Individual
RYAN C MAURER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
S3712 WOODLAND RD, VIROQUA, WI 54665-8153
(262) 977-4052
Mailing address
S3712 WOODLAND RD, VIROQUA, WI 54665-8153
(262) 977-4052
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0809M50494
MEDI SHARE
WI
Enumeration date
05/25/2015
Last updated
05/25/2015
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