Individual
KORA PEARL LUSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4051 BROAD ST STE 110, SAN LUIS OBISPO, CA 93401-8722
(805) 242-1617
Mailing address
15726 MORRO RD, ATASCADERO, CA 93422-1015
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
07/09/2024
Last updated
07/09/2024
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