Provider Demographics
NPI:1598131161
Name:YOUREY, LUCAS (DPT)
Entity Type:Individual
Prefix:
First Name:LUCAS
Middle Name:
Last Name:YOUREY
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:649 S GARFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:FRACKVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17931-2427
Mailing Address - Country:US
Mailing Address - Phone:570-874-2125
Mailing Address - Fax:570-874-4091
Practice Address - Street 1:649 S GARFIELD AVE
Practice Address - Street 2:
Practice Address - City:FRACKVILLE
Practice Address - State:PA
Practice Address - Zip Code:17931-2427
Practice Address - Country:US
Practice Address - Phone:570-874-2125
Practice Address - Fax:570-874-4091
Is Sole Proprietor?:No
Enumeration Date:2015-08-18
Last Update Date:2015-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT024513225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist