Provider Demographics
NPI:1942450960
Name:LUKJANCZUK, ANDREW J (ATC)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:J
Last Name:LUKJANCZUK
Suffix:
Gender:M
Credentials:ATC
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Mailing Address - Street 1:604 WALNUT CROSSING DR
Mailing Address - Street 2:
Mailing Address - City:WHITSETT
Mailing Address - State:NC
Mailing Address - Zip Code:27377-9308
Mailing Address - Country:US
Mailing Address - Phone:336-278-6800
Mailing Address - Fax:336-278-6767
Practice Address - Street 1:2500 CAMPUS BOX
Practice Address - Street 2:ELON UNIVERSITY AT DEPARTMENT
Practice Address - City:ELON
Practice Address - State:NC
Practice Address - Zip Code:27244-9308
Practice Address - Country:US
Practice Address - Phone:336-278-6800
Practice Address - Fax:336-278-6767
Is Sole Proprietor?:No
Enumeration Date:2008-09-26
Last Update Date:2008-09-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NCNC11392255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCNC1139OtherSTATE LICENSE