Individual
MARICELA LUCCHETTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2707 15TH PL, KENOSHA, WI 53140-4947
(262) 551-2700
(262) 553-9150
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
17080-24
WI
225200000X
Physical Therapy Assistant
160.008743
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100307544
—
WI
Enumeration date
06/19/2022
Last updated
03/11/2025
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