Individual
MICHAEL LUCKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
C.A.
Contact information
Practice address
380 BRADLEY AVE, DELAVAN, WI 53115-1924
(608) 756-4444
Mailing address
380 BRADLEY AVE, DELAVAN, WI 53115-1924
(608) 756-4444
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
65-055
WI
Other
Enumeration date
04/03/2009
Last updated
04/03/2009
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