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1144218389
RYAN A LUCAS
SOUTH PORTLAND, ME
NPI
1144218389
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: ME AT190)
Enumeration Date
2005-10-12
Last Update Date
2007-07-08
Business Address
-- RYAN A LUCAS A.T.C.
100 FODEN RD SUITE 103 WEST
SOUTH PORTLAND, ME 04106-2319
Phone number: 207-772-2625
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Mailing Address
-- RYAN A LUCAS A.T.C.
69 EUCLID AVE
PORTLAND, ME 04103-1200
Phone number: 207-831-7540
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