Provider Demographics
NPI:1942624440
Name:LUCAS, JANE ALEXANDER (DPT)
Entity Type:Individual
Prefix:DR
First Name:JANE
Middle Name:ALEXANDER
Last Name:LUCAS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2321 PARK AVE
Mailing Address - Street 2:APARTMENT A
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23220-2607
Mailing Address - Country:US
Mailing Address - Phone:843-814-1154
Mailing Address - Fax:
Practice Address - Street 1:108 WALTON PARK LN
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23114-3028
Practice Address - Country:US
Practice Address - Phone:804-560-9575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-05
Last Update Date:2014-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305208349225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist