Individual
MARY HELEN WIECZOREK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC/LAT
Contact information
Practice address
770 N 12TH ST, MILWAUKEE, WI 53233-2203
(414) 288-0328
(414) 288-6477
Mailing address
4050 S LAKE DR APT 3, ST FRANCIS, WI 53235-5255
(414) 759-1773
(414) 288-6477
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1420-39
WI
Other
Enumeration date
08/31/2017
Last updated
06/15/2020
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