Individual
LAURA STAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8190 S GIFFIN LN, LAKE NEBAGAMON, WI 54849-9049
(218) 590-4060
Mailing address
8190 S GIFFIN LN, LAKE NEBAGAMON, WI 54849-9049
(218) 590-4060
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
01/22/2020
Last updated
01/22/2020
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