Individual
NATHAN M BRINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC LAT
Contact information
Practice address
2305 WILLIS MILLER DR, HUDSON, WI 54016
(715) 386-1155
(715) 386-1105
Mailing address
483 COUNTRY VIEW RD, HUDSON, WI 54016-7819
(715) 222-3847
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1005-39
WI
Other
Enumeration date
06/23/2011
Last updated
06/23/2011
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