Individual
JENNIFER LUSTIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
255 UNION BLVD STE 110, LAKEWOOD, CO 80228-1833
(303) 232-0355
Mailing address
10700 CHADSWORTH LN, HIGHLANDS RANCH, CO 80126-7510
(303) 346-8049
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PTA
LICENSE #
CO
Enumeration date
08/30/2006
Last updated
07/08/2007
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