LUCAS EDWARDS

GODFREY, IL
NPI1790315018
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: IL  085.007325)
Enumeration Date2020-01-26
Last Update Date2020-01-26
Business Address
LUCAS EDWARDS
6702 GODFREY RD
GODFREY, IL 62035-2205
Phone number: 618-467-1540
Mailing Address
LUCAS EDWARDS
4901 CROWN POINT PL APT A
ALTON, IL 62002-5073
Phone number:
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