Individual
KELLY LUSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5013 HOLYOKE WAY, SACRAMENTO, CA 95841-3022
(916) 283-5013
Mailing address
5013 HOLYOKE WAY, SACRAMENTO, CA 95841-3022
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
07/28/2013
Last updated
07/28/2013
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