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1295987410
MICAH DANIELLE LUST
LUBBOCK, TX
NPI
1295987410
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: TX PA05964)
Enumeration Date
2008-10-21
Last Update Date
2022-11-29
Business Address
Mrs. MICAH DANIELLE LUST PA-C
5004 122ND ST STE 200
LUBBOCK, TX 79424-8398
Phone number: 469-734-8689
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Mailing Address
Mrs. MICAH DANIELLE LUST PA-C
7008 INDIANA AVE STE. A
LUBBOCK, TX 79413-6114
Phone number: 806-698-8088
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