Individual
MR. MARK JOSEPH SNIADECKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT
Contact information
Practice address
285 FOREST GROVE DR, PEWAUKEE, WI 53072-3782
(877) 732-2262
Mailing address
PO BOX 250, PEWAUKEE, WI 53072-0250
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
286-39
WI
Other
Enumeration date
02/06/2018
Last updated
02/06/2018
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