Individual
BRANDON MICHAEL PENNINGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
224 WISCONSIN AVE, DENMARK, WI 54208-9737
(920) 713-0702
Mailing address
224 WISCONSIN AVE, DENMARK, WI 54208-9737
(920) 713-0702
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000019385
WI
Other
Enumeration date
03/30/2015
Last updated
03/30/2015
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