Individual
LUCAS ALLEN BOSQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
401 E SPRUCE ST, GARDEN, KS 67846
(620) 272-2222
Mailing address
2306 GRAND VIEW DR EAST, GARDEN, KS 67846-6784
(785) 531-9642
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
14-03307
KS
Other
Enumeration date
06/26/2023
Last updated
06/26/2023
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