Individual
JAMES R BEVERSDORF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT, CSCS, PES
Contact information
Practice address
215 N WEBSTER AVE, GREEN BAY, WI 54301-4813
(920) 430-4750
Mailing address
1330 PACKERLAND DR, APT. B-3, GREEN BAY, WI 54304-1388
(920) 405-0872
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
24-039
WI
Other
Enumeration date
09/19/2005
Last updated
07/08/2007
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