Stacy Lueckeman

NPI #1336623495 in Burton, Michigan

Provider Information

NPI Number: 1336623495
Entity Type: Individual
Name: Stacy Lueckeman
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Enumeration Date: Sep 24, 2018
Last Updated: Sep 24, 2018

Practice Location

Address: 6173 GREENVIEW CT
City: Burton
State: Michigan
ZIP Code: 48509-2607
Phone: (810) 347-7468

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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