Basic Information
| Provider Information | |||||||||
| NPI: | 1003002957 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LUCAS | ||||||||
| FirstName: | SUZANNE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | L.AC. | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 12821 N CAVE CREEK RD | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850225862 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6024048483 | ||||||||
| FaxNumber: | 6024932246 | ||||||||
| Practice Location | |||||||||
| Address1: | 12821 N CAVE CREEK RD | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850225862 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6024048483 | ||||||||
| FaxNumber: | 6024932246 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/24/2007 | ||||||||
| LastUpdateDate: | 09/24/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 171100000X | 0192 | AZ | Y | Other Service Providers | Acupuncturist |
No ID Information.