Individual
JOSHUA BRELLENTHIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, ATC, LAT
Contact information
Practice address
2420 NICOLET DR, GREEN BAY, WI 54311-7003
(262) 203-0194
(920) 465-2652
Mailing address
2420 NICOLET DR, GREEN BAY, WI 54311-7003
(262) 203-0194
(920) 465-2652
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1191-39
WI
Other
Enumeration date
11/11/2014
Last updated
11/11/2014
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