Individual
BRYANA KELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAT
Contact information
Practice address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-3000
Mailing address
5727 HILLCREST LN, WEST BEND, WI 53090-9354
(262) 483-6486
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1729-39
WI
Other
Enumeration date
05/23/2017
Last updated
05/23/2017
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