Individual
DR. GREGORY CHARLES LUCAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
168 EAST AVE, TALLMADGE, OH 44278-2311
(330) 633-1909
Mailing address
168 EAST AVE, TALLMADGE, OH 44278-2311
(330) 633-1909
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
1134
SC
111N00000X
Chiropractor
Primary
1513
OH
111N00000X
Chiropractor
4296
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000136021
ANTHEM INSURANCE
OH
Enumeration date
06/26/2005
Last updated
03/25/2013
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