Provider Demographics
NPI:1205227857
Name:STUCKEY, MATTHEW (LAC)
Entity type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:
Last Name:STUCKEY
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 1:166 E LIMBERLOST DR UNIT 102
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85705-8816
Mailing Address - Country:US
Mailing Address - Phone:360-746-0240
Mailing Address - Fax:
Practice Address - Street 1:166 E LIMBERLOST DR UNIT 102
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85705-8816
Practice Address - Country:US
Practice Address - Phone:360-746-0240
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-17
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ012261171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist