Individual
MRS. SUSAN MARY LEW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LAT, CSCS
Contact information
Practice address
220 13TH AVE E, MENOMONIE, WI 54751-1671
(715) 232-2213
(715) 232-4081
Mailing address
N3365 1010TH ST, EAU CLAIRE, WI 54703-7116
(715) 874-4161
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
356-039
WI
Other
Enumeration date
11/09/2006
Last updated
07/08/2007
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