Provider Demographics
NPI:1255465654
Name:LUCK, MARSHALL (DC)
Entity Type:Individual
Prefix:DR
First Name:MARSHALL
Middle Name:
Last Name:LUCK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 HOWARD ST
Mailing Address - Street 2:GROUND FLOOR, SUITE D
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94105-1629
Mailing Address - Country:US
Mailing Address - Phone:415-896-2225
Mailing Address - Fax:415-243-8292
Practice Address - Street 1:101 HOWARD ST
Practice Address - Street 2:GROUND FLOOR, SUITE D
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94105-1629
Practice Address - Country:US
Practice Address - Phone:415-896-2225
Practice Address - Fax:415-243-8292
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC23047111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor