Provider Demographics
NPI:1275897720
Name:PRITCHARD, LUKE (LAC)
Entity Type:Individual
Prefix:
First Name:LUKE
Middle Name:
Last Name:PRITCHARD
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20010 SWEETGUM CIR
Mailing Address - Street 2:APT 13
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20874-3760
Mailing Address - Country:US
Mailing Address - Phone:805-591-9258
Mailing Address - Fax:
Practice Address - Street 1:20528 BOLAND FARM RD
Practice Address - Street 2:SUITE 211
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20876-4021
Practice Address - Country:US
Practice Address - Phone:805-591-9258
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-29
Last Update Date:2012-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU01988171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist