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NPI Code Detail

MEDICARE: NICOLE LUCUS PT

MEDICARE: NICOLE LUCUS PT
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 Therapist015482OH

General Provider Information

NPI Number : 1366823569
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE LUCUS PT
Provider Business Mailing Address
First Line : 2780 AIRPORT DR STE 100
Second Line :
City : COLUMBUS
State : OH
Zip : 43219-2289
Country : US
Telephone Number : 614-859-1906
Fax Number :
Provider Business Practice Location Address
First Line : 1905 PARSONS AVE
Second Line :
City : COLUMBUS
State : OH
Zip : 43207-1933
Country : US
Telephone Number : 614-859-1967
Fax Number : 614-586-4252
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/12/2015
Last Update Date : 01/10/2023

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Directions to “ NICOLE LUCUS PT” Practice Location

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