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NICOLE ANGELA WEBER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LAT

Contact information

Practice address
12800 N LAKE SHORE DR, MEQUON, WI 53097-2418
(262) 397-7914
Mailing address
655 SIMON DR, HARTFORD, WI 53027-9266
(262) 397-7914

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
3008-39
WI
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
09/11/2019
Last updated
07/13/2022
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