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1780180497
JOHN LUCAS RUNDE
SAINT LOUIS, MO
NPI
1780180497
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: MO 2015036002)
Enumeration Date
2018-04-02
Last Update Date
2018-04-02
Business Address
JOHN LUCAS RUNDE
5201 MID AMERICA PLZ
SAINT LOUIS, MO 63129-0002
Phone number: 217-663-4090
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Mailing Address
JOHN LUCAS RUNDE
8861 GILMORE LAKE RD
COLUMBIA, IL 62236-3525
Phone number: 217-663-4090
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