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1083065213
CAROLINE LISEE
EAST LANSING, MI
NPI
1083065213
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: VA 0126002369)
Enumeration Date
2016-06-29
Last Update Date
2016-06-29
Business Address
-- CAROLINE LISEE MEd, ATC
1 IM SPORTS CIR 308 W. CIRCLE DRIVE
EAST LANSING, MI 48824-1049
Phone number: 862-432-2171
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Mailing Address
-- CAROLINE LISEE MEd, ATC
105A STRIBLING AVE
CHARLOTTESVILLE, VA 22903-2940
Phone number: 862-432-2171
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