Individual
JANE DAVENPORT LUCAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
264 BEACON ST, BOSTON, MA 02116-1236
(617) 266-6621
(617) 266-2115
Mailing address
264 BEACON STREET, DBA BACK BAY PHYSICAL THERAPY, BOSTON, MA 02116
(617) 266-6621
(617) 266-2115
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4529
MA
Other
Enumeration date
08/09/2006
Last updated
07/08/2007
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