Individual
MR. CARLTON LEO LAUCKERN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
34505 W 12 MILE RD STE 100, FARMINGTON HILLS, MI 48331-3287
(734) 343-7500
Mailing address
10280 KELLY RD, PINCKNEY, MI 48169-9004
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501001427
MI
Other
Enumeration date
12/10/2018
Last updated
12/10/2018
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