Individual
MR. KENNETH DAVID LUCZAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1122 TAYLOR ST, ZANESVILLE, OH 43701-2658
(740) 588-2182
Mailing address
5915 SUGAR GROVE RD, CAMBRIDGE, OH 43725-9271
(740) 541-0099
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT10054
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2620186
—
OH
Enumeration date
09/17/2006
Last updated
07/08/2007
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