Individual
DR. LUCAS WATSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1320 S AMMON RD, AMMON, ID 83406-5810
(509) 551-5365
Mailing address
1320 S AMMON RD, AMMON, ID 83406-5810
(509) 551-5365
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
CH60697756
WA
111N00000X
Chiropractor
Primary
TCHI-2041
ID
Other
Enumeration date
02/02/2017
Last updated
12/01/2020
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