Individual
MRS. LISA RAE PARKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AT/ATC
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT-1179
OH
Other
Enumeration date
10/03/2014
Last updated
10/03/2014
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