SearchIdaho103K00000X

Derek Lucky

NPI 1467687459 · on the registry since 2009 · sole proprietor

Practice

Address
2831 N White Pines Dr
Coeur D Alene, ID 83815
Phone
(208) 640-3538

Registry record

Primary taxonomy
103K00000X
103K00000X
Sex
Male
Record last updated
2009-05-20

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho