Individual
MISS HEIDI SUE NEUSTIFTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC/L
Contact information
Practice address
1818 N MEADE ST, APPLETON, WI 54911-3454
(920) 716-8136
Mailing address
1818 N MEADE ST, APPLETON, WI 54911-3454
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
308-039
WI
Other
Enumeration date
06/25/2008
Last updated
06/25/2008
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