Individual
LYNN EDMUNDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAT
Contact information
Practice address
368 FOND DU LAC ST, WAUPUN, WI 53963-1511
(414) 839-4476
Mailing address
368 FOND DU LAC ST, WAUPUN, WI 53963-1511
(414) 839-4476
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
494039
WI
Other
Enumeration date
09/03/2014
Last updated
09/03/2014
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