Individual
NICOLE LUSK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
120 E HARRIS AVE, SAN ANGELO, TX 76903-5904
(325) 481-8532
Mailing address
120 E HARRIS AVE, SAN ANGELO, TX 76903-5904
(325) 481-8532
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT84059
TX
Other
Enumeration date
12/01/2015
Last updated
12/01/2015
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