Individual
MRS. CANDACE LEIGH LUSK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
RT 10 THREE MILE CURVE RD, LOGAN, WV 25601
(304) 752-2273
Mailing address
PO BOX 211, KOPPERSTON, WV 24854-0211
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1381
WV
Other
Enumeration date
03/22/2007
Last updated
07/08/2007
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