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Individual

LUCY BOURESSA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2105 E. ENTERPRISE AVE, 113, APPLETON, WI 54913
(920) 991-2561
(920) 991-2563
Mailing address
2105 E. ENTERPRISE AVE, 113, APPLETON, WI 54913
(920) 991-2561
(920) 991-2563

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary

Other

Enumeration date
11/19/2015
Last updated
11/19/2015
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