Individual
MR. MARK THOMAS HUSEN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
1630 COMMANCHE AVE, GREEN BAY, WI 54313-5753
(920) 430-4750
(920) 430-4746
Mailing address
1630 COMMANCHE AVE, GREEN BAY, WI 54313-5753
(920) 430-4750
(920) 430-4746
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
86-039
WI
Other
Enumeration date
09/06/2005
Last updated
07/08/2007
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