Individual
SAMUEL LAWRENCE KONRATH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
712 BROADWAY ST S, MENOMONIE, WI 54751-2458
(414) 573-6009
Mailing address
503 BROADWAY ST S APT 403, MENOMONIE, WI 54751-3095
(414) 573-6009
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2466
WI
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
05/06/2018
Last updated
10/14/2021
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