BETHANY ALTA SHAW

MILWAUKEE, WI
NPI1225003684
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: WI  693-039)
Enumeration Date2006-02-21
Last Update Date2007-07-08
Business Address
Mrs. BETHANY ALTA SHAW ATC, LAT
2025 E NEWPORT AVE
MILWAUKEE, WI 53211-2906
Phone number: 414-961-4666
Mailing Address
Mrs. BETHANY ALTA SHAW ATC, LAT
1720 E CAPITOL DR #212
SHOREWOOD, WI 53211-1951
Phone number: 414-234-6130
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