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Individual

MISS SARAH IRENE LUKEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LAT, ATC

Contact information

Practice address
7883 N STATE ROAD 39, LIZTON, IN 46149-9575
(317) 994-4090
Mailing address
8227 NORTHWEST BLVD, SUITE 160, INDIANAPOLIS, IN 46278-1387

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36001510A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
36001510A
INDIANA PROFESSIONAL LICENSING AGENCY
IN
Enumeration date
09/08/2011
Last updated
09/08/2011
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