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1801300488
LAURISA RICHARD
ALLENDALE, MI
NPI
1801300488
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist Athletic Trainer
(Licence: MI 2601001760)
Enumeration Date
2017-11-19
Last Update Date
2017-11-19
Business Address
LAURISA RICHARD ATC
1 CAMPUS DR
ALLENDALE, MI 49401-9401
Phone number: 616-331-9385
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Mailing Address
LAURISA RICHARD ATC
430 STEPHEN ST
HUNTINGTON, IN 46750-2022
Phone number: 260-388-3408
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