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General NPI Number Information
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NPI Number | 1922386796
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Entity Type | Individual
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Provider Name | ERICKA IRENE LUCAS PT, DPT, OCS
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Gender | Female
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Dates
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Enumeration Date | 07/28/2011
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Last Update Date | 11/16/2023
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Provider Practice Location Address
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Address Line | 292 HARVEST DR
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City | HAYDEN
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State | CO
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Zip | 81639
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Country | US
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Telephone | 419-349-1879
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 927
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City | HAYDEN
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State | CO
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Zip | 81639-0927
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Country | US
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Telephone | 419-349-1879
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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 | 11339
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License Number State | CO
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