Individual
BRIAN LENTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
12800 N LAKE SHORE DR, MEQUON, WI 53097-2418
(262) 243-2057
Mailing address
1123 RIDGE CREEK CIR UNIT 102, WAUKESHA, WI 53186-4207
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2253-39
WI
Other
Enumeration date
07/09/2019
Last updated
07/22/2019
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