Individual
MARY JO LUSIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1532 ELLIS STREET, STE 201, BOZEMAN, MT 59715
(406) 587-4501
(406) 587-3919
Mailing address
1532 ELLIS STREET, STE 201, BOZEMAN, MT 59715
(406) 587-4501
(406) 587-3919
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
121PT
MT
Other
Enumeration date
07/15/2006
Last updated
01/09/2008
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