Individual
GINA LUCKIANOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1940 ELMER J BISSELL RD, BIRMINGHAM, AL 35243-2941
(205) 638-4949
Mailing address
1940 ELMER J BISSELL RD, BIRMINGHAM, AL 35243-2941
(205) 638-4949
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1060
AL
363AS0400X
Surgical Physician Assistant
001512
CT
Other
Enumeration date
06/22/2009
Last updated
09/22/2020
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