Individual
MARY LACY LUSK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
3827 JIMMY LEE SMITH PKWY STE 122, HIRAM, GA 30141-2804
(770) 943-1142
Mailing address
1295 DRESDEN DR NE UNIT 221, BROOKHAVEN, GA 30319-5858
(662) 832-1675
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
PT017621
GA
Other
Enumeration date
03/03/2025
Last updated
03/03/2025
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