Individual
MARY LUCAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6900 WEST COUNTRY CLUB DRIVE, HUNTINGTON, WV 25705
(304) 733-1060
Mailing address
RR 1 BOX 187, MILTON, WV 25541-9738
(304) 743-5437
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2502
WV
Other
Enumeration date
12/20/2006
Last updated
07/08/2007
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