Lukas Dominic Manieri, ATC, OTC
NPI #1164939179 in Bloomington, Illinois
Provider Information
- NPI Number
- 1164939179
- Entity Type
- Individual
- Name
- Lukas Dominic Manieri, ATC, OTC
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Specialist/Technologist - Athletic Trainer
- Credential
- ATC, OTC
- Enumeration Date
- Dec 29, 2017
- Last Updated
- Dec 29, 2017
Practice Location
- Address
- 1111 TRINITY LN STE 111
- City
- Bloomington
- State
- Illinois
- ZIP Code
- 61704-8112
- Phone
- (309) 663-6461
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist/Technologist, Other - Orthopedic Assistant — Orthopedic Assistant |
| Specialist/Technologist - Athletic Trainer — Athletic Trainer |
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