NPI | 1225531825 |
---|---|
Former Name | SHONNY ROLSTON-LUECK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: CO AT.0000574) |
Enumeration Date | 2018-03-10 |
Last Update Date | 2018-03-10 |