Individual
BETHANY LUSK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
189 QUINCY ST, BROCKTON, MA 02302-2967
(508) 588-6700
(508) 584-3010
Mailing address
189 QUINCY ST, BROCKTON, MA 02302-2967
(508) 588-6700
(508) 584-3010
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
MA
133VN1006X
Metabolic Nutrition Registered Dietitian
—
MA
Other
Enumeration date
03/03/2016
Last updated
12/08/2017
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