Individual
CORIANNA LUCKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
44201 DEQUINDRE RD, TROY, MI 48085-1117
(248) 964-4866
(248) 964-4848
Mailing address
26901 BEAUMONT BLVD # 3D, SOUTHFIELD, MI 48033-3849
(947) 522-1952
(947) 522-0307
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601004155
MI
Other
Enumeration date
03/03/2006
Last updated
07/28/2022
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