# MR. ROBBY S LUCK

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1063568533
- **Gender:** Man
- **Credential:** PT

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 63179552401 | UT | Yes |

## Other

- **Enumeration date:** 01/26/2007
- **Last updated:** 08/22/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1063568533 | — | UT |
| 01 | — | 63179552400001 | REGENCE BLUE CROSS BLUE S | UT |