Individual
LUKE JAMES DETTLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5N600 IL ROUTE 25, SAINT CHARLES, IL 60174-5613
(630) 846-8271
Mailing address
5N600 IL ROUTE 25, SAINT CHARLES, IL 60174-5613
(630) 846-8271
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
04/22/2015
Last updated
04/22/2015
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