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1689053779
GUSTA MICHELLE OWENS
LAFAYETTE, IN
NPI
1689053779
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: IN 36001127A)
Enumeration Date
2015-05-22
Last Update Date
2015-05-22
Business Address
Mrs. GUSTA MICHELLE OWENS ATC
1411 S CREASY LN STE 120
LAFAYETTE, IN 47905-7438
Phone number: 765-447-4165
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Mailing Address
Mrs. GUSTA MICHELLE OWENS ATC
1411 S CREASY LN STE 120
LAFAYETTE, IN 47905-7438
Phone number: 765-447-4165
Copy
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