Individual
MS. BEVERLY ANTOINETTE LUCKETT-TORRENCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
756 N 35TH ST STE 203, MILWAUKEE, WI 53208
(414) 763-1237
Mailing address
1300 S. GREEN BAY ROAD, SUITE #205, RACINE, WI 53406
(262) 898-3930
(262) 898-3933
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
976-019
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
976-019
—
WI
Enumeration date
04/23/2008
Last updated
06/10/2018
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