Individual
MIA M LUKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R MR
Contact information
Practice address
1401 TIFT AVE N, STE E, TIFTON, GA 31794-3585
(229) 387-6799
(229) 387-6791
Mailing address
1401 TIFT AVE N, STE E, TIFTON, GA 31794-3585
(229) 387-6799
(229) 387-6791
Taxonomy
Speciality
Code
Description
License number
State
247100000X
Radiologic Technologist
409616
GA
2471M1202X
Magnetic Resonance Imaging Radiologic Technologist
Primary
409616
GA
Other
Enumeration date
10/04/2013
Last updated
10/09/2013
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