Individual
MS. AMANDA KAY LUSTIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
808 MAIN ST E, MENOMONIE, WI 54751-2735
(715) 232-1116
(715) 232-5987
Mailing address
N12697 350TH ST, BOYCEVILLE, WI 54725-9459
(715) 949-1630
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
L232-0117-8560-09
WI
Other
Enumeration date
03/16/2007
Last updated
07/08/2007
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