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1114917580
ANGELA YVONNE PUCHALLA
GREEN BAY, WI
NPI
1114917580
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: WI 549-039)
Enumeration Date
2005-10-26
Last Update Date
2007-07-08
Business Address
-- ANGELA YVONNE PUCHALLA LAT, ATC
1630 COMMANCHE AVE
GREEN BAY, WI 54313-5753
Phone number: 920-655-3005
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Mailing Address
-- ANGELA YVONNE PUCHALLA LAT, ATC
1445 CARROLL AVE
GREEN BAY, WI 54304-3412
Phone number:
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