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Individual

MR. MICHAEL STEPHEN LACKNEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CORPSMAN

Contact information

Practice address
DTHC ARLINGTON NAVY ANNEX CLINIC, F.O.B. #2 ROOM 1323, WASHINGTON, DC 20370-0001
(703) 614-2726
(703) 614-1593
Mailing address
DTHC ARLINGTON NAVY ANNEX CLINIC, F.O.B. #2 ROOM 1323, WASHINGTON, DC 20370-0001
(703) 614-2726
(703) 614-1593

Taxonomy

Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary

Other

Enumeration date
11/17/2008
Last updated
11/17/2008
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