Lucas Daniel Raymond, MSPT
Individual provider Active NPI Physical Therapist · Wyalusing, PA
NPI 1659622207 · NPPES record last updated Sep 23, 2012
Key facts
- NPI
- 1659622207
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT022292 (PA)
- Practice address
- 42 Complex Dr
Wyalusing, PA 18853-7803 - Phone
- (570) 746-0504
- NPI assigned
- Sep 23, 2012
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pivot Physical Therapy of Pennsylvania, LLC | Physical Therapist | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT022292 | PA | Yes |
Addresses
Primary practice location
42 Complex Dr
Wyalusing, PA 18853-7803
Mailing address
42 Complex Dr
Wyalusing, PA 18853-7803
Phone (570) 746-0504
Other providers in Wyalusing, PA
- Millers Pharmacy Inc
- Millers Pharmacy Inc
- Leon A Mosher Jr.
- Olivia Noone
- Jeffrey Carl Pitcher
- Marcus Andrew Redline
- Robert Ottaviani OD
- Sierra Schertler
- Alexandrea Steele
- Ali R Valentine
All providers in Wyalusing, PA · Physical Therapist in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 23, 2012. 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.