Individual
DR. SUSAN WILBANKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD, ATC, CSCS
Contact information
Practice address
1200 N 62ND ST APT 317, WAUWATOSA, WI 53213-3068
(847) 312-0407
Mailing address
1200 N 62ND ST APT 317, WAUWATOSA, WI 53213-3068
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
11/02/2016
Last updated
09/21/2017
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