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Individual

MR. GREGORY T LUCAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
ATC

Contact information

Practice address
323 S 18TH AVE, STURGEON BAY, WI 54235-1401
(920) 746-0410
Mailing address
2722 COUNTY RD N, BRUSSELS, WI 54204-9775
(920) 824-5792

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
89-039
WI

Other

Enumeration date
07/05/2007
Last updated
07/08/2007
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