Harold Lucas
Individual provider Active NPI Physical Therapist · Malden, MO
NPI 1306274386 · NPPES record last updated Oct 29, 2013
Key facts
- NPI
- 1306274386
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 2011037091 (MO)
- Practice address
- 500 Barrett Dr
Malden, MO 63863-1204 - Phone
- (573) 276-3843
- NPI assigned
- Oct 29, 2013
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2011037091 | MO | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2011037091 | MO | Yes |
Addresses
Primary practice location
500 Barrett Dr
Malden, MO 63863-1204
Mailing address
1413 Ballard St
Kennett, MO 63857-1503
Phone (310) 951-2443
Other providers in Malden, MO
- Joseph E. Pehlman
- Grace Christine Keathley
- Sarah Knight
- Kristen Danielle Lalk
- Ethan D Lucas
- Malden Chiropractic Health Center, P.C.
- Malden Chiropractic L.L.C.
- Malden Family Dentistry, LLC
- Malden N & R LLC
- Malden R-I School District
All providers in Malden, MO · Physical Therapist in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 29, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.