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1912090770
BRIAN MITCHEL LACKEY
GASTONIA, NC
NPI
1912090770
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
163WC1500X Registered Nurse, Community Health
(Licence: NC 138742)
Enumeration Date
2006-10-02
Last Update Date
2007-07-08
Business Address
Mr. BRIAN MITCHEL LACKEY RN
991 WEST HUDSON BLVD
GASTONIA, NC 28052
Phone number: 704-853-5083
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Mailing Address
Mr. BRIAN MITCHEL LACKEY RN
991 WEST HUDSON BLVD
GASTONIA, NC 28052
Phone number: 704-853-5083
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