RYAN EDWARD VANDERVEST

GREEN BAY, WI
NPI1285609941
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: WI  626-039)
Enumeration Date2006-02-17
Last Update Date2007-07-08
Business Address
Mr. RYAN EDWARD VANDERVEST MS, LAT, CSCS
760 PILGRIM WAY
GREEN BAY, WI 54304-5263
Phone number: 920-496-4750
Mailing Address
Mr. RYAN EDWARD VANDERVEST MS, LAT, CSCS
2840 CHAR LA MAR DR
GREEN BAY, WI 54311-6573
Phone number: 920-496-4750