Michael Juckett

NPI 1629272869 - Counselor - 101YA0400X

NPI Details
NPI 1629272869
Gender Male
Enumeration Date 06/12/2007
Last Updated 07/08/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
1137 EMERALD BAY RD
SOUTH LAKE TAHOE CA, 96150-6207, US
Phone (530) 541-5190
Fax
Business Location
PO BOX 16435
SOUTH LAKE TAHOE CA, 96151-6435, US
Phone (530) 208-8171
Fax
Toxanomy
Taxonomy Code 101YA0400X
License State
License Number
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According to our database, Mr. Michael Juckett NPI is 1629272869, taxonomy code is 101YA0400X Michael Juckett physically located at 1137 Emerald Bay Rd, South Lake Tahoe CA, 96150-6207. NPI Number Michael Juckett has the Individual type.

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1629272869 NPI number is provided on an as is basis without warranty of any kind. 1629272869 is maintained by the National Plan & Provider Enumeration System. The contents of Michael Juckett are for informational purposes only.