Individual
MS. KAMIE JOY LUCAS
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
1600 E WASHINGTON BLVD, INDIANA INSTITUTE OF TECHNOLOGY, FORT WAYNE, IN 46803
(260) 422-5561
Mailing address
1922 ARDMORE AVE, APT. 54, FORT WAYNE, IN 46802-4824
(260) 557-5400
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36001232A
IN
Other
Enumeration date
03/20/2006
Last updated
07/08/2007
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