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Individual

SCOTT L LUCAS

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
132 N LAFAYETTE AVENUE, MOUNDSVILLE, WV 26041-1029
(304) 845-9550
(304) 845-9540
Mailing address
132 N LAFAYETTE AVENUE, MOUNDSVILLE, WV 26041-1029
(304) 845-9550
(304) 845-9540

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2463
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3810001875
WV
Enumeration date
05/17/2006
Last updated
07/08/2007
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