Individual
MR. LUCAS JOHN KERANEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
86032 COUNTY HIGHWAY 61, WILLOW RIVER, MN 55795-3216
(218) 372-3101
Mailing address
52808 WILD HAVEN RD, BRUNO, MN 55712-3082
(320) 838-1432
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1550
MN
Other
Enumeration date
06/29/2007
Last updated
07/08/2007
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