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Individual
MICHAELA BROOKE LUPO
Active
Individual
MICHAELA BROOKE LUPO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
11-06290
KS
225100000X
Physical Therapist
2019021794
MO
225100000X
Physical Therapist
Primary
63427
OR
Other
Enumeration date
08/23/2019
Last updated
08/23/2019
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