Individual
MR. CEDRIC MICHAEL LUCKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
355 RIDGE RUN TRL, IRMO, SC 29063-8667
(803) 271-2364
Mailing address
201 BEAVER CREEK DR, COLUMBIA, SC 29223-7756
(803) 419-9626
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1242
SC
Other
Enumeration date
10/03/2013
Last updated
10/03/2013
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