Individual
NICHOLE CARSTENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
1100 GATEWAY CT, WEST BEND, WI 53095-8539
(262) 306-6100
Mailing address
1100 GATEWAY CT, WEST BEND, WI 53095-8539
(262) 306-6100
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
931-039
WI
Other
Enumeration date
11/06/2007
Last updated
01/21/2014
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