Individual
MS. ETERNITY VICTORIA LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAT, ATC
Contact information
Practice address
1555 S ODELL ST, BROWNSBURG, IN 46112-8041
(317) 457-0906
Mailing address
615 ASPIRE CT APT 105, PLAINFIELD, IN 46168-5665
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36003455A
IN
Other
Enumeration date
04/18/2018
Last updated
11/10/2021
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