Individual
KOBE JOSEPH LUCARELLI I
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
10627 DIEBOLD RD, FORT WAYNE, IN 46845-8606
(260) 357-8329
Mailing address
511 N FRANKLIN ST, GARRETT, IN 46738-1034
(260) 357-8329
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
IN
Other
Enumeration date
01/29/2024
Last updated
01/29/2024
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