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General NPI Number Information
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NPI Number | 1144798828
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Entity Type | Individual
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Provider Name | CHELSEA NICOLE LUCAS PT, DPT, CMTPT
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Gender | Female
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Dates
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Enumeration Date | 11/11/2018
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Last Update Date | 09/14/2023
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Provider Practice Location Address
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Address Line | 525 E MARKET ST STE B
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City | LEESBURG
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State | VA
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Zip | 20176-4171
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Country | US
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Telephone | 703-443-6700
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Fax |
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Provider Business Mailing Address
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Address Line | 215 CALMES ST
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City | CHARLES TOWN
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State | WV
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Zip | 25414-5397
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Country | US
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Telephone | 443-897-9621
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT004395
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT.9410
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | CP015738T
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License Number State | VA
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