Individual
ELAINE KATE LUSTGARTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LAT, ATC
Contact information
Practice address
9042 COLUMBIA AVE STE B, MUNSTER, IN 46321-2928
(219) 836-4461
Mailing address
379 E 500 N, VALPARAISO, IN 46383-8333
(219) 669-8318
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000033970
IN
Other
Enumeration date
12/16/2018
Last updated
12/16/2018
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