Individual
DANTE LUCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
405 GROVE ST, FAIRBORN, OH 45324-3068
(937) 873-2225
Mailing address
405 GROVE ST, FAIRBORN, OH 45324-3068
(937) 873-2225
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
08/06/2021
Last updated
08/06/2021
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