Provider Information for 1366126989
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SARAH LUCAS
Sex: Female
NPI: 1366126989
Last Updated: 2023-06-14
Certification Date: 2023-06-13
Certification Date: 2023-06-13
Details
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NPI | 1366126989 | ||||||||
Enumeration Date | 2023-06-14 | ||||||||
NPI Type | NPI-1 Individual | ||||||||
Sole Proprietor | YES | ||||||||
Status | Active | ||||||||
Mailing Address | 2404 LOU LN WICHITA FALLS, TX 76308-3907 United States Phone: 940-636-9391 | Fax: | ||||||||
Primary Practice Address | 2404 LOU LN WICHITA FALLS, TX 76308-3907 United States Phone: 940-636-9391 | Fax: | ||||||||
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