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Individual

JUSTIN A EDGE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
ATC

Contact information

Practice address
45 S NATIONAL AVE, FOND DU LAC, WI 54935-4621
(920) 923-8588
Mailing address
407 HARRISON ST APT 14, NORTH FOND DU LAC, WI 54937-1582
(608) 444-2911

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary

Other

Enumeration date
09/05/2022
Last updated
09/05/2022
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