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Individual

MR. LUCAS DWAYNE DARGO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
ATC

Contact information

Practice address
4121 W PICKELL ST, MUNCIE, IN 47303-9344
(765) 716-9272
Mailing address
4121 W PICKELL ST, MUNCIE, IN 47303-9344

Taxonomy

Speciality
Code
Description
License number
State
174H00000X
Health Educator
10067876
IN
2255A2300X
Athletic Trainer
Primary

Other

Enumeration date
06/11/2013
Last updated
06/11/2013
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