Individual
MRS. SHANNON CATHLEEN LUSTILA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
201 HEMATITE ST, HIBBING, MN 55746-3129
(218) 263-4840
Mailing address
201 HEMATITE ST, HIBBING, MN 55746-3129
(218) 263-4840
Taxonomy
Speciality
Code
Description
License number
State
177F00000X
Lodging Provider
Primary
222281-1-AFC
MN
Other
Enumeration date
12/30/2006
Last updated
07/08/2007
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