Individual
LAURA FAITH MANCUSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
1971 UNIVERSITY BLVD, LYNCHBURG, VA 24515-0002
(434) 582-7458
Mailing address
1971 UNIVERSITY BLVD, LYNCHBURG, VA 24515-0002
(434) 582-7458
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000012715
FL
Other
Enumeration date
02/26/2019
Last updated
02/26/2019
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