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Individual
LISA CUSTER
Active
Individual
LISA CUSTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD, ATC
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
A0001128
MD
2255A2300X
Athletic Trainer
AT004080
OH
Other
Enumeration date
06/10/2013
Last updated
09/09/2020
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