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General NPI Number Information
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NPI Number | 1669436754
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Entity Type | Individual
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Provider Name | KENNETH E LUKE ATC, L.AC.
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Gender | Male
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Dates
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Enumeration Date | 04/14/2006
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Last Update Date | 07/14/2009
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Provider Practice Location Address
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Address Line | 820 GRAVENSTEIN HIGHWAY SOUTH SUITE 100
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City | SEBSTOPOL
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State | CA
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Zip | 95472
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Country | US
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Telephone | 707-494-9286
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Fax |
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Provider Business Mailing Address
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Address Line | 708 GRAVENSTEIN HWY N SUITE 237
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City | SEBASTOPOL
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State | CA
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Zip | 95472-2808
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC 7331
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License Number State | CA
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