Individual
DALTON LUSK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3203 E OLD STONE AVE, BROOKLINE, MO 65619-9620
(417) 269-1910
Mailing address
3203 E OLD STONE AVE, BROOKLINE, MO 65619-9620
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2022024064
MO
Other
Enumeration date
07/12/2022
Last updated
07/12/2022
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