Individual
JULIAN LUCERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
148 SPARTAN ALLEY, BERNALILLO, NM 87004-6298
(505) 867-2338
Mailing address
PO BOX 1323, BERNALILLO, NM 87004-1323
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT617
NM
Other
Enumeration date
08/10/2019
Last updated
09/02/2021
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