Provider Demographics
NPI:1710356910
Name:CAMP, LUCAS (DC)
Entity Type:Individual
Prefix:DR
First Name:LUCAS
Middle Name:
Last Name:CAMP
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 1:100 FORD DR
Mailing Address - Street 2:APT. 1
Mailing Address - City:INDIANA
Mailing Address - State:PA
Mailing Address - Zip Code:15701-9403
Mailing Address - Country:US
Mailing Address - Phone:724-357-9030
Mailing Address - Fax:724-357-9031
Practice Address - Street 1:100 FORD DR
Practice Address - Street 2:APT. 1
Practice Address - City:INDIANA
Practice Address - State:PA
Practice Address - Zip Code:15701-9403
Practice Address - Country:US
Practice Address - Phone:724-357-9030
Practice Address - Fax:724-357-9031
Is Sole Proprietor?:No
Enumeration Date:2015-09-17
Last Update Date:2017-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC011055111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor