Individual
CONNIE S LUKACS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN, ROF
Contact information
Practice address
6243 ANDREWS DR E, WESTERVILLE, OH 43082-9313
(614) 818-3301
(614) 818-3302
Mailing address
6243 ANDREWS DR E, WESTERVILLE, OH 43082-9313
(614) 818-3301
(614) 818-3302
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000334932
ANTHEM
OH
01
—
200513653003
MEDICAL MUTUAL
OH
05
—
2506167
—
OH
Enumeration date
11/20/2006
Last updated
10/17/2007
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