Individual
RYAN KOEBERL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC LAT
Contact information
Practice address
W3718 SOUTH DR, PLYMOUTH, WI 53073-4878
(920) 565-1024
Mailing address
2032 SAVANNA DR, JANESVILLE, WI 53546-4012
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1515-39
WI
Other
Enumeration date
01/19/2015
Last updated
01/19/2015
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