Individual
JOSEPH DI BIASE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
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
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1147-39
WI
2255A2300X
Athletic Trainer
2601001392
MI
Other
Enumeration date
03/15/2015
Last updated
03/15/2015
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