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Individual

LONUIS LUCKY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CNA

Contact information

Practice address
1625 CONLEY RD. 222, CONLEY, GA 30288
(770) 318-1064
Mailing address
1625 CONLEY RD. 222, CONLEY, GA 30288
(770) 318-1064

Taxonomy

Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
374U00000X
Home Health Aide
376K00000X
Nurse's Aide
CN0030007375
GA

Other

Enumeration date
07/20/2012
Last updated
07/20/2012
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