Individual
NICKEY LOUIS WOLFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.A.T.
Contact information
Practice address
N63W23075 STATE HIGHWAY 74, SUSSEX, WI 53089-2876
(414) 566-4586
(414) 566-4640
Mailing address
2757 N 74TH ST, WAUWATOSA, WI 53210-1009
(414) 774-2658
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
95-039
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
95-039
STATE LICENSE
WI
Enumeration date
01/09/2007
Last updated
07/08/2007
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