Provider Demographics
NPI:1548756729
Name:FARABEE, LUCAS ANDREW (DC)
Entity Type:Individual
Prefix:
First Name:LUCAS
Middle Name:ANDREW
Last Name:FARABEE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9984 ALDER SPRINGS CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-5772
Mailing Address - Country:US
Mailing Address - Phone:660-251-1923
Mailing Address - Fax:
Practice Address - Street 1:4530 S EASTERN AVE STE 6
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-6181
Practice Address - Country:US
Practice Address - Phone:702-369-6242
Practice Address - Fax:702-369-6269
Is Sole Proprietor?:No
Enumeration Date:2018-07-10
Last Update Date:2018-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB01697111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor