Individual
MICAHEL DELUCA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
141 MOBY ARENA, FORT COLLINS, CO 80523-0001
(970) 491-6756
Mailing address
2802 IOWA DR UNIT 104, FORT COLLINS, CO 80525-4344
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
CO
Other
Enumeration date
07/01/2016
Last updated
07/01/2016
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