Individual
EMILY ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAT
Contact information
Practice address
1100 GATEWAY CT, WEST BEND, WI 53095
(262) 306-6100
(262) 306-6105
Mailing address
1100 GATEWAY CT, WEST BEND, WI 53095-8539
(262) 573-5333
(262) 306-3105
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
689-039
WI
Other
Enumeration date
09/20/2006
Last updated
03/31/2020
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