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1073177705
SAM ADAM MASON
ONALASKA, WI
NPI
1073177705
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: WI 2099-39)
Enumeration Date
2019-04-29
Last Update Date
2019-04-29
Business Address
SAM ADAM MASON LAT, ATC
3111 GUNDERSEN DR
ONALASKA, WI 54650-8447
Phone number: 608-775-8100
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Mailing Address
SAM ADAM MASON LAT, ATC
2111 MISSISSIPPI ST
LA CROSSE, WI 54601-5074
Phone number: 763-443-4020
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