Individual
JESSICA LUBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1282 CONCORDIA AVE, SAINT PAUL, MN 55104-5479
(651) 641-8853
Mailing address
1282 CONCORDIA AVE, SAINT PAUL, MN 55104-5479
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2605
MN
Other
Enumeration date
04/18/2017
Last updated
04/18/2017
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