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NPI Code Detail

MEDICARE: MICHAEL LUCAS

MEDICARE: MICHAEL LUCAS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistPT03825RI

General Provider Information

NPI Number : 1255850210
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL LUCAS
Provider Business Mailing Address
First Line : 960 WILLIAM T MORRISSEY BLVD
Second Line :
City : DORCHESTER
State : MA
Zip : 02122-3206
Country : US
Telephone Number : 617-506-7210
Fax Number :
Provider Business Practice Location Address
First Line : 175 NATE WHIPPLE HWY STE 201
Second Line :
City : CUMBERLAND
State : RI
Zip : 02864-1423
Country : US
Telephone Number : 401-999-7325
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/11/2017
Last Update Date : 02/24/2025

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Directions to “ MICHAEL LUCAS ” Practice Location

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