Individual
SONY LUKOSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
21401 MACK AVE, GROSSE POINTE WOODS, MI 48236-1048
(586) 778-0800
Mailing address
34542 HEARTSWORTH LN, STERLING HEIGHTS, MI 48312-5739
(248) 747-2181
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
5501016122
MI
Other
Enumeration date
03/26/2018
Last updated
03/26/2018
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