Luke James Dettlo
NPI #1962899443 in Saint Charles, Illinois
Provider Information
- NPI Number
- 1962899443
- Entity Type
- Individual
- Name
- Luke James Dettlo
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Specialist/Technologist - Athletic Trainer
- Enumeration Date
- Apr 22, 2015
- Last Updated
- Apr 22, 2015
Practice Location
- Address
- 5N600 IL ROUTE 25
- City
- Saint Charles
- State
- Illinois
- ZIP Code
- 60174-5613
- Phone
- (630) 846-8271
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist/Technologist - Athletic Trainer — Athletic Trainer |
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