Provider Demographics
NPI:1861165250
Name:ZASTROW, LUCAS DONALD (PT, DPT, OCS)
Entity type:Individual
Prefix:
First Name:LUCAS
Middle Name:DONALD
Last Name:ZASTROW
Suffix:
Gender:M
Credentials:PT, DPT, OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1502 WORTHINGTON PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-5405
Mailing Address - Country:US
Mailing Address - Phone:419-346-5735
Mailing Address - Fax:
Practice Address - Street 1:7844 GREEN MEADOWS DRIVE
Practice Address - Street 2:
Practice Address - City:LEWIS CENTER
Practice Address - State:OH
Practice Address - Zip Code:43035-9444
Practice Address - Country:US
Practice Address - Phone:740-549-7041
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-30
Last Update Date:2021-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT0180122251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic