Individual
MARK LUCKENBACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1751 US HIGHWAY 27 S, SEBRING, FL 33870-4920
(863) 386-1599
(863) 386-1699
Mailing address
PO BOX 8135, SEBRING, FL 33872-0119
(863) 386-1599
(863) 386-1699
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
TT10397
FL
Other
Enumeration date
07/17/2006
Last updated
07/08/2007
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