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General NPI Number Information
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NPI Number | 1376509620
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Entity Type | Individual
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Provider Name | CRAIG JOHN LUCAS D.C.
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Gender | Male
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Dates
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Enumeration Date | 04/25/2006
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Last Update Date | 03/20/2012
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Provider Practice Location Address
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Address Line | 21626 ROUTE 68
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City | CLARION
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State | PA
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Zip | 16214-3826
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Country | US
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Telephone | 814-226-5441
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Fax | 814-226-5491
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Provider Business Mailing Address
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Address Line | 119 THORN APPLE DR
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City | BUTLER
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State | PA
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Zip | 16001-2329
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Country | US
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Telephone | 724-283-0518
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Fax | 724-283-8543
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC006468L
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License Number State | PA
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