Individual
MARCHELL LUCKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7005 QUAIL LAKES DR, HOLLAND, OH 43528-9390
(919) 345-3130
Mailing address
7005 QUAIL LAKES DR, HOLLAND, OH 43528-9390
(919) 345-3130
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
—
—
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
07/22/2014
Last updated
02/20/2024
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