Individual
SALLIE LUCKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
313 E 27TH ST, SCOTTSBLUFF, NE 69361-1762
(308) 635-6247
Mailing address
1722 1ST AVE, SCOTTSBLUFF, NE 69361-2401
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
75946
NE
Other
Enumeration date
09/10/2018
Last updated
09/10/2018
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