Individual
KYLE J BERRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
333 E. SECOND ST, RICHLAND CENTER, WI 53581
(608) 647-6321
Mailing address
P.O. BOX 338, NORTH FREEDOM, WI 53951
(608) 522-4693
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
573-039
WI
Other
Enumeration date
10/16/2007
Last updated
10/16/2007
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