Individual
MISS MADISON ELAINE LUCKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6071 RIDGE RUN DR NW, WARREN, OH 44481-9022
(330) 240-7158
Mailing address
6071 RIDGE RUN DR NW, WARREN, OH 44481-9022
(330) 240-7158
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
03/04/2025
Last updated
03/04/2025
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