Lucas Ray Moake

NPI #1780545863 in Lebanon, Illinois

Provider Information

NPI Number: 1780545863
Entity Type: Individual
Name: Lucas Ray Moake
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Student in an Organized Health Care Education/Training Program
Enumeration Date: Nov 19, 2025
Last Updated: Nov 19, 2025

Practice Location

Address: 701 COLLEGE RD
City: Lebanon
State: Illinois
ZIP Code: 62254-1291
Phone: (618) 232-7228

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Student in an Organized Health Care Education/Training Program	390200000X	Primary

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