Individual
RONALD DEAN LUCKHARDT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5617 CLEARY ROAD NW,, ANOKA, MN 55303-9624
(763) 226-9356
Mailing address
5617 CLEARY ROAD NW,, ANOKA, MN 55303-9624
(763) 226-9356
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
01/02/2020
Last updated
01/02/2020
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