LUCAS LEE VAN WAY

BEAUFORT, SC
NPI1902486921
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy208D00000X General Practice
(Licence: VA  0102207551)
Additional Taxonomies171000000X Military Health Care Provider
(Licence: VA  0102207551)
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2021-04-13
Last Update Date2024-02-16
Business Address
Dr. LUCAS LEE VAN WAY DO
598 GEIGER BLVD
BEAUFORT, SC 29904
Phone number: 843-228-7186
Mailing Address
Dr. LUCAS LEE VAN WAY DO
MARINE FIGHTER ATTACK SQUADRON 312 PSC BOX 66122
BEAUFORT, ZZ
Phone number: