Individual
JEFFERY LUCAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD/ABD, OTR/L
Contact information
Practice address
2501 DOWNING ST SW, WILSON, NC 27893-4517
(252) 237-6300
Mailing address
1101 CAYMUS RD APT 211, CHESAPEAKE, VA 23320-7514
(252) 236-2705
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
0119006732
VA
225X00000X
Occupational Therapist
Primary
9985
NC
Other
Enumeration date
10/13/2015
Last updated
10/13/2015
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