Individual
MR. THORNE MICHAEL WITTSTRUCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BS CES RCEP
Contact information
Practice address
707 14TH ST, BARABOO, WI 53913-1539
(608) 356-1481
Mailing address
707 14TH ST, BARABOO, WI 53913-1539
(608) 356-1481
Taxonomy
Speciality
Code
Description
License number
State
224Y00000X
Clinical Exercise Physiologist
Primary
—
—
Other
Enumeration date
01/17/2013
Last updated
01/17/2013
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