Individual
MITCHELL THOMAS O'NEIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT, ATC
Contact information
Practice address
1810 CATLIN AVE, SUPERIOR, WI 54880
(763) 355-7083
Mailing address
1305 E 4TH ST, SUPERIOR, WI 54880-3350
(763) 355-7083
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2411
WI
2255A2300X
Athletic Trainer
3232
MN
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
03/09/2017
Last updated
09/13/2021
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