Individual
MISS JESSICA IVALLA LUCAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
529 COFFMAN ST, LONGMONT, CO 80501-5450
(303) 245-4473
Mailing address
11446 FAR VW, LONGMONT, CO 80504-6280
(970) 581-6121
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
04/20/2007
Last updated
07/08/2007
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