Individual
LISA RENEE BUSSERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8700 OAKLAND STOUTSVILLE RD SW, AMANDA, OH 43102-9553
(740) 503-4092
Mailing address
8700 OAKLAND STOUTSVILLE RD SW, AMANDA, OH 43102-9553
(740) 503-4092
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
LPN.148873.MEDS-IV
OH
Other
Enumeration date
01/22/2021
Last updated
01/22/2021
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