Individual
DANIEL HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT
Contact information
Practice address
1160 KEPLER DR, GREEN BAY, WI 54311-8321
(920) 288-5400
Mailing address
1160 KEPLER DR, GREEN BAY, WI 54311-8321
(920) 288-5400
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
438039
WI
Other
Enumeration date
02/18/2015
Last updated
02/18/2015
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