Provider Demographics
NPI:1801949326
Name:LUCIA, GEORGE WILLIAM JR (DC)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:WILLIAM
Last Name:LUCIA
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:3275 ROBINHOOD RD
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27106-5463
Mailing Address - Country:US
Mailing Address - Phone:336-768-8338
Mailing Address - Fax:336-768-8318
Practice Address - Street 1:3275 ROBINHOOD RD
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27106-5463
Practice Address - Country:US
Practice Address - Phone:336-768-8338
Practice Address - Fax:336-768-8318
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2009-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3427111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor