Individual
ETHAN D LUCAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
500 BARRETT THRIVE, MALDEN, MO 63863
(573) 888-5925
Mailing address
500 BARRETT THRIVE, MALDEN, MO 63863
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
03/20/2025
Last updated
03/20/2025
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