MEDICARE: DR. LUCAS MAYNARD DC

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	111N00000X	Chiropractor	DC-05318	OH

General Provider Information

NPI Number	:	1558180489
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LUCAS MAYNARD DC

Provider Business Mailing Address
First Line	:	3504 SECOR RD STE 325
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43606-1545
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3504 SECOR RD STE 325
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43606-1545
Country	:	US
Telephone Number	:	419-273-9601
Fax Number	:

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

Provider Enumeration Date	:	10/08/2024
Last Update Date	:	10/08/2024

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Directions to “ DR. LUCAS MAYNARD DC” Practice Location

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