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1386068955
ANTHONY JARED LUCCA
SPRINGFIELD, IL
NPI
1386068955
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363A00000X Physician Assistant
Enumeration Date
2014-02-18
Last Update Date
2014-02-18
Business Address
Mr. ANTHONY JARED LUCCA PA-C
701 N 1ST ST
SPRINGFIELD, IL 62781-0001
Phone number: 217-788-3156
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Mailing Address
Mr. ANTHONY JARED LUCCA PA-C
1119 INTERLACKEN RD
SPRINGFIELD, IL 62704-2129
Phone number: 217-622-5975
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