Individual
ETHAN WILLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
59 S BROWN ST, RHINELANDER, WI 54501-3450
(715) 513-6121
Mailing address
59 S BROWN ST, RHINELANDER, WI 54501-3450
(715) 513-6121
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2402-39
WI
2255A2300X
Athletic Trainer
Primary
RT006072
PA
Other
Enumeration date
07/31/2017
Last updated
05/02/2026
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