Individual
DANIEL PATRICK LUSTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
215 FAIRVIEW AVE, CHICOPEE, MA 01013-2925
(413) 592-6890
Mailing address
215 FAIRVIEW AVE, CHICOPEE, MA 01013-2925
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
10/19/2007
Last updated
10/19/2007
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