Provider Demographics
NPI:1205865185
Name:LUCEY, DAVID W (ATC)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:W
Last Name:LUCEY
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 GLENN ST
Mailing Address - Street 2:
Mailing Address - City:REED CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49677-9739
Mailing Address - Country:US
Mailing Address - Phone:231-832-3240
Mailing Address - Fax:
Practice Address - Street 1:210 SPORTS DR
Practice Address - Street 2:
Practice Address - City:BIG RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49307-2741
Practice Address - Country:US
Practice Address - Phone:231-591-2868
Practice Address - Fax:231-591-2869
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist