Individual
LUPANA REGINA MORALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
35 CIRCLE DR, EDWARDSVILLE, IL 62026-2210
(618) 650-2160
Mailing address
BOX 1129, VC 2210, EDWARDSVILLE, IL 62026-0001
(618) 650-2169
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
096.005602
IL
Other
Enumeration date
12/13/2013
Last updated
12/16/2024
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