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Joseph G Lugo

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NPI Number Detailed Information

Provider Information:

Name: Joseph G Lugo
Gender: M
Provider License Number If Given: 2002012685

NPI Information:

NPI: 1770582223
Entity Type
(Individual or Organization):
1-ind
Enumeration Date: 7/18/2005

Last Update Date: 7/29/2016

Provider Business Mailing Address:

Address: PO BOX 122152 DEPT 2152
Dallas, TX 75312
Phone Number: 3374943278
Fax Number: 3374946969

Provider Business Practice Location Address:

Address: 222 S WOODS MILL RD SUITE 550-N
Chesterfield, MO 63017
Phone Number: 3144343049
Fax Number: 3142056916

Provider Taxonomy:

Primary: 208G00000X
Secondary (if any):
State: MO

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