Individual
MR. LUCAS SOLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, LAT, CSCS
Contact information
Practice address
2335 W MANCHESTER AVE, MILWAUKEE, WI 53221-3413
(414) 378-4721
Mailing address
2335 W MANCHESTER AVE, MILWAUKEE, WI 53221-3413
(414) 378-4721
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
898-39
WI
Other
Enumeration date
07/18/2014
Last updated
07/18/2014
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