Individual
MR. JARED ELIJAH TRAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT, ATC
Contact information
Practice address
1147 YUBA ST, JANESVILLE, WI 53545-1037
(608) 295-5212
Mailing address
1147 YUBA ST, JANESVILLE, WI 53545-1037
(608) 295-5212
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
3000-39
WI
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
07/27/2020
Last updated
08/09/2022
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