Provider Demographics
NPI:1841720463
Name:VALLEE, LUCAS RYAN (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:MR
First Name:LUCAS
Middle Name:RYAN
Last Name:VALLEE
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
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Mailing Address - Street 1:1650 CENTRAL AVE STE A
Mailing Address - Street 2:
Mailing Address - City:MCKINLEYVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95519-4389
Mailing Address - Country:US
Mailing Address - Phone:707-839-5905
Mailing Address - Fax:707-839-5907
Practice Address - Street 1:3800 JANES RD
Practice Address - Street 2:
Practice Address - City:ARCATA
Practice Address - State:CA
Practice Address - Zip Code:95521-4742
Practice Address - Country:US
Practice Address - Phone:707-839-5905
Practice Address - Fax:707-839-5907
Is Sole Proprietor?:No
Enumeration Date:2017-06-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA36091225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist