Individual
MARCKENSON LUCIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
151 S OAK AVE STE 7, SAN LUIS, AZ 85336-0756
(928) 366-5166
Mailing address
PO BOX 617, SOMERTON, AZ 85350-0617
(928) 315-7910
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9545
AZ
Other
Enumeration date
02/27/2023
Last updated
10/26/2023
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