Lucas Queen, 1205262375

NPI #1205262375 in Ottawa, Kansas

Provider Information

NPI Number: 1205262375
Entity Type: Individual
Name: Lucas Queen, 1205262375
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physical Therapy Assistant
Credential: 1205262375
Enumeration Date: Sep 20, 2013
Last Updated: Sep 20, 2013

Practice Location

Address: 327 S WILLOW ST
City: Ottawa
State: Kansas
ZIP Code: 66067-2149
Phone: (785) 214-9090

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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