Individual
MARISSA EVONNE LUCAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSAT, ATC
Contact information
Practice address
4400 SW 20TH AVE APT 5201, GAINESVILLE, FL 32607-3902
(732) 404-7867
Mailing address
24 OAKLAND RD, JAMESBURG, NJ 08831-1340
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
NC
Other
Enumeration date
01/14/2019
Last updated
07/07/2020
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