Individual
MR. DILLON JOHN FASSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAT, ATC
Contact information
Practice address
W156N9000 PILGRIM RD, MENOMONEE FALLS, WI 53051-2272
(262) 502-8752
Mailing address
W290S4827 PARKE LN W, WAUKESHA, WI 53189-9047
(262) 391-7952
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1929-39
WI
Other
Enumeration date
03/10/2017
Last updated
03/10/2017
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