Provider Demographics
NPI:1508092404
Name:LUCAS, JEANAY HELENE WHYE (DC)
Entity Type:Individual
Prefix:DR
First Name:JEANAY
Middle Name:HELENE WHYE
Last Name:LUCAS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3301 BELAIR RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21213-1257
Mailing Address - Country:US
Mailing Address - Phone:410-732-6110
Mailing Address - Fax:
Practice Address - Street 1:3301 BELAIR RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21213-1257
Practice Address - Country:US
Practice Address - Phone:410-732-6110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-05
Last Update Date:2013-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEF1-0000661111N00000X
MDS03726111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NR0400XChiropractic ProvidersChiropractorRehabilitation