Individual
JARED M LUKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MED, ATC, LAT
Contact information
Practice address
256 RALEIGH WAY, VILLA RICA, GA 30180-7020
(678) 787-9291
Mailing address
256 RALEIGH WAY, VILLA RICA, GA 30180-7020
(678) 787-9291
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT001443
GA
Other
Enumeration date
11/12/2007
Last updated
06/05/2014
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