Autumn Lukezech

NPI #1134638521 in Sandpoint, Idaho

Provider Information

NPI Number: 1134638521
Entity Type: Individual
Name: Autumn Lukezech
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Massage Therapist
Enumeration Date: Sep 28, 2017
Last Updated: Sep 28, 2017

Practice Location

Address: 102 S EUCLID AVE STE 111
City: Sandpoint
State: Idaho
ZIP Code: 83864-4916
Phone: (512) 516-9144

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Massage Therapist	225700000X	Primary

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