Individual
PATRICIA WANKUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
12800 N LAKE SHORE DR, MEQUON, WI 53097-2418
(262) 243-4537
Mailing address
2305 SW WESTMINSTER DR, LEES SUMMIT, MO 64082-4060
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
11/28/2017
Last updated
11/28/2017
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