Individual
MR. ROBBY S LUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
5547 S 4015 W, #7, TAYLORSVILLE, UT 84118-4429
(801) 967-6055
(801) 967-6934
Mailing address
5547 S 4015 W, #7, TAYLORSVILLE, UT 84118-4429
(801) 967-6055
(801) 967-6934
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
63179552401
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1063568533
—
UT
01
—
63179552400001
REGENCE BLUE CROSS BLUE S
UT
Enumeration date
01/26/2007
Last updated
08/22/2007
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