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Contact Information

LUKAS M PASSALACQUA, MSAT, ATC
900 N JOHN R WOODEN DR
WEST LAFAYETTE, IN47907
 Phone: 765-494-3245
 Fax: 765-494-9899
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Athletic Trainer

2255A2300X
Indicates primary specialty

NPI Profile & details for LUKAS M PASSALACQUA · (Male)

NPI Number 1104314046
Status Active
Credentials MSAT, ATC
Entity Individual
Enumeration date 04/26/2018
Last updated 11/26/2019 - About 7 years ago
Sole proprietor 1 No
Identifiers
  • AZ License # 1631
  • IN License # 36003098A
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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