Individual
BRYTTNIE NICOLE LUCAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6000 SANTA CLARA DR, FARMINGTON, NM 87402-5166
(505) 860-4385
Mailing address
6000 SANTA CLARA DR, FARMINGTON, NM 87402-5166
(505) 860-4385
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-2024-0029
NM
Other
Enumeration date
01/23/2024
Last updated
01/23/2024
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