Individual
MARVIN LUCAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
22 OAKBROOKE DR, SHERWOOD, AR 72120-3174
(510) 613-6715
Mailing address
22 OAKBROOKE DR, SHERWOOD, AR 72120-3174
(510) 613-6715
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
A6108099
AR
Other
Enumeration date
01/09/2017
Last updated
01/09/2017
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