MEDICARE: LESHA 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
1	225400000X	Rehabilitation Practitioner

General Provider Information

NPI Number	:	1588082705
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LESHA LUCAS

Provider Business Mailing Address
First Line	:	6948 DUNSBACH WAY APT B
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89156-6119
Country	:	US
Telephone Number	:	888-906-9929
Fax Number	:	888-892-3669

Provider Business Practice Location Address
First Line	:	6948 DUNSBACH WAY APT B
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89156-6119
Country	:	US
Telephone Number	:	888-906-9929
Fax Number	:	888-892-3669

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/03/2014
Last Update Date	:	04/03/2014

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Directions to “ LESHA LUCAS ” Practice Location

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