Individual
NICOLE REITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12800 N LAKE SHORE DR, MEQUON, WI 53097-2418
(262) 707-9137
Mailing address
290 BLEY PKWY, PORT WASHINGTON, WI 53074-9659
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2114
WI
Other
Enumeration date
12/19/2018
Last updated
12/19/2018
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