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1023575198
LAURA FAITH MANCUSO
LYNCHBURG, VA
NPI
1023575198
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: FL 2000012715)
Enumeration Date
2019-02-26
Last Update Date
2019-02-26
Business Address
LAURA FAITH MANCUSO ATC
1971 UNIVERSITY BLVD
LYNCHBURG, VA 24515-0002
Phone number: 434-582-7458
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Mailing Address
LAURA FAITH MANCUSO ATC
1971 UNIVERSITY BLVD
LYNCHBURG, VA 24515-0002
Phone number: 434-582-7458
Copy
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