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Individual

AMANDA LEIGH LUSKY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ATC

Contact information

Practice address
1 S GROVE ST, WESTERVILLE, OH 43081-2004
(614) 823-3533
Mailing address
87 LANCELOT LN, WESTERVILLE, OH 43081-2825
(412) 897-0016

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT005221
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
AT005221
LICENSURE
OH
Enumeration date
11/25/2019
Last updated
11/25/2019
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