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Individual

LUKE HENRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1951 EAST 21ST STREET, FLORENCE, OR 97439
(478) 494-2026
Mailing address
PO BOX 13143, BIRMINGHAM, AL 35202
(478) 494-2026

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
292152
OR
225X00000X
Occupational Therapist
Primary
3377
AL
225X00000X
Occupational Therapist
8400439-4201
UT

Other

Enumeration date
09/12/2012
Last updated
09/12/2012
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