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NPI Code Detail

MEDICARE: LUCAS CARR

MEDICARE: LUCAS CARR
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
12251X0800XOrthopedic Physical Therapist13154AZ

General Provider Information

NPI Number : 1801311089
Entity Type Code : Individual
Provider Name (Legal Business Name) : LUCAS CARR
Provider Business Mailing Address
First Line : 1045 W 2ND ST
Second Line :
City : TEMPE
State : AZ
Zip : 85281-2942
Country : US
Telephone Number : 307-751-1685
Fax Number :
Provider Business Practice Location Address
First Line : 5353 N 16TH ST STE 120
Second Line :
City : PHOENIX
State : AZ
Zip : 85016-3282
Country : US
Telephone Number : 602-826-0037
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/08/2017
Last Update Date : 08/08/2017

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Directions to “ LUCAS CARR ” Practice Location

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