Individual
LIZET MORENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1970 S RIDGE RD, GREEN BAY, WI 54304-4125
(920) 371-6964
Mailing address
510 BLUEBIRD LN, GREEN BAY, WI 54303-2319
(920) 371-6964
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
WI
Other
Enumeration date
01/19/2023
Last updated
08/07/2024
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