Provider Demographics
NPI:1851042618
Name:WERTH, LUCAS DANIEL (DC)
Entity Type:Individual
Prefix:
First Name:LUCAS
Middle Name:DANIEL
Last Name:WERTH
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 1:2050 LANGHORNE RD STE 202
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24501-1402
Mailing Address - Country:US
Mailing Address - Phone:434-771-2210
Mailing Address - Fax:
Practice Address - Street 1:2050 LANGHORNE RD STE 202
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24501-1402
Practice Address - Country:US
Practice Address - Phone:434-771-2210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-13
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104557790111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor