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1679638746
STEVEN MICHAEL STAAB
WAUKESHA, WI
NPI
1679638746
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: WI 631-039)
Enumeration Date
2006-12-27
Last Update Date
2007-07-08
Business Address
Mr. STEVEN MICHAEL STAAB LAT, PES-NASM
100 N EAST AVE VAN MALE TRAINING ROOM
WAUKESHA, WI 53186-3103
Phone number: 262-524-7379
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Mailing Address
Mr. STEVEN MICHAEL STAAB LAT, PES-NASM
2012 CLIFF ALEX CT S UNIT D
WAUKESHA, WI 53189-2127
Phone number: 262-391-9495
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