Individual
KEVAN M CREIGHTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
4529 N OAKLAND AVE, SHOREWOOD, WI 53211-1216
(414) 232-9781
Mailing address
4529 N OAKLAND AVE, SHOREWOOD, WI 53211-1216
(414) 232-9781
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1125-39
WI
Other
Enumeration date
05/21/2010
Last updated
08/15/2024
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