| NPI | 1427033919 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHAD CARTER Licensed Athletic Trainer 920-430-4750 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: WI 383-039) |
| Enumeration Date | 2005-12-07 |
| Last Update Date | 2020-08-22 |