Individual
LUCAS JONATHAN FULTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1737 S NAPERVILLE RD STE 200, WHEATON, IL 60189-5894
(630) 653-9700
Mailing address
120 E OGDEN AVE STE 220, HINSDALE, IL 60521-3546
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
07/22/2019
Last updated
07/22/2019
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