JAY JOSEPH DAVIDE

APPLETON, WI
NPI1477515989
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: WI  164039)
Enumeration Date2006-04-03
Last Update Date2007-07-08
Business Address
Mr. JAY JOSEPH DAVIDE LAT
820 E GRANT ST
APPLETON, WI 54911-3483
Phone number: 920-716-8137
Mailing Address
Mr. JAY JOSEPH DAVIDE LAT
1191 TRAILWOOD DR
DE PERE, WI 54115-1045
Phone number: 920-339-0233