Individual
KASI MARIE BARDOUCHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2884 SUSSEX RD, GREEN BAY, WI 54311-7475
(920) 217-2174
Mailing address
2884 SUSSEX RD, GREEN BAY, WI 54311-7475
(920) 217-2174
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
05/01/2018
Last updated
05/01/2018
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