Individual
MR. JASON A. NUTTALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
1050 DIVISION ST, MAUSTON, WI 53948-1931
(608) 847-1421
Mailing address
1050 DIVISION ST, MAUSTON, WI 53948-1931
(608) 847-1421
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
781-039
WI
Other
Enumeration date
12/06/2007
Last updated
12/01/2008
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