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Individual

MS. LISA LOUISE LUCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS

Contact information

Practice address
2524 FIRST AVE, KETCHIKAN, AK 99901-5804
(907) 202-8745
(907) 885-6613
Mailing address
PO BOX 7475, KETCHIKAN, AK 99901-2475
(907) 202-8745
(907) 885-6613

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
AK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1021118
AK
05
1584706
AK
Enumeration date
11/23/2020
Last updated
11/23/2020
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