Individual
MICHEAL ISAAC LUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
71 N 50 W, TOOELE, UT 84074
(801) 990-4300
(801) 967-2127
Mailing address
PO BOX 330, MAGNA, UT 84044-0330
(801) 990-4300
(801) 967-2127
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/07/2024
Last updated
03/07/2024
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