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1548790348
JENNIFER LYNN LUPER-LARK
FORT THOMPSON, SD
NPI
1548790348
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: SD 0490)
Enumeration Date
2017-06-14
Last Update Date
2017-06-14
Business Address
JENNIFER LYNN LUPER-LARK ATC
1323 BIA ROUTE 4
FORT THOMPSON, SD 57339
Phone number: 605-245-1621
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Mailing Address
JENNIFER LYNN LUPER-LARK ATC
647 SIMMONS AVE SE
HURON, SD 57350-2955
Phone number:
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