Individual
JASON LUBBEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
4401 PEAK DR, SUITE 1, LOVES PARK, IL 61111-8001
(815) 668-7700
Mailing address
4401 PEAK DR, SUITE 1, LOVES PARK, IL 61111-8001
(815) 668-7700
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096001953
IL
Other
Enumeration date
11/21/2014
Last updated
11/21/2014
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