Organization
BELLINHEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHAD CARTER LAT (LICENSED ATHLETIC TRAINER)
(920) 430-4750
Entity
Organization
Contact information
Practice address
1630 COMMANCHE AVE, GREEN BAY, WI 54313-5753
(920) 430-4750
Mailing address
1630 COMMANCHE AVE, GREEN BAY, WI 54313-5753
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
383-039
WI
Other
Enumeration date
12/07/2005
Last updated
08/22/2020
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