| Organization Name: | LUCK MEDICAL CLINIC |
| NPI Number: | 1649435876 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SCOTT EDIN (CFO ADMINISTRATOR FINANCE) |
| Mailing Address: | 137 1st Ave Luck |
| State: | WI US |
| Postal Code: | 54853 |
| Phone Number: | 7154722177 |
| Fax Number: | 7154728787 |
| NPI Enumeration Date: | 07/28/2008 |
| NPI Last Update Date: | 07/28/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Radiology |
| Taxonomy Definition: | |