Individual provider · NPI-1

Lucas Jude Archuleta

Specialist/Technologist, Athletic Trainer · Las Cruces, NM

NPI number1770048852
StatusActive
Last updated in NPPESFeb 4, 2019

Details

NPI
1770048852
Entity type
Individual (NPI-1)
Name
Lucas Jude Archuleta
Sex
Male
Sole proprietor
Yes
Enumeration date
Feb 4, 2019
Last updated
Feb 4, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2255A2300X Specialist/Technologist, Athletic Trainer–NMYes
390200000X Student in an Organized Health Care Education/Training Program––

Practice location

1815 Wells St
Las Cruces, NM 88003-1304

Phone 505-470-7734

Mailing address

15 Amor Rd
Pecos, NM 87552-2511

Phone 505-470-7734

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