Provider Demographics
NPI:1376262154
Name:LUKETIN, LORNA VALERIE
Entity Type:Individual
Prefix:
First Name:LORNA
Middle Name:VALERIE
Last Name:LUKETIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 RACQUET CLUB RD
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-3142
Mailing Address - Country:US
Mailing Address - Phone:865-255-5103
Mailing Address - Fax:
Practice Address - Street 1:100 RIDGEFIELD CT
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28806-2270
Practice Address - Country:US
Practice Address - Phone:828-418-1346
Practice Address - Fax:828-274-6110
Is Sole Proprietor?:No
Enumeration Date:2022-08-24
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP21336225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist