Individual
LUCAS P MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, LAT, ATC
Contact information
Practice address
620 MICHIGAN AVE NE, WASHINGTON, DC 20064-0001
(614) 563-2919
Mailing address
620 MICHIGAN AVE NE, WASHINGTON, DC 20064-0001
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0126002158
VA
Other
Enumeration date
09/15/2017
Last updated
04/24/2018
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