Individual
AMANDA LUCAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
U
Credential
PA
Contact information
Practice address
1200 E BROADWAY, COLUMBIA, MO 65201-4978
(573) 441-5107
Mailing address
1200 E BROADWAY, COLUMBIA, MO 65201-4978
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
2006039114
MO
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
05/23/2007
Last updated
09/17/2024
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