Individual
JEROD KEENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, LAT, ATC
Contact information
Practice address
333 E CAMPUS MALL # 5140, MADISON, WI 53715-1365
(608) 890-1959
Mailing address
333 E CAMPUS MALL # 5140, MADISON, WI 53715-1365
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1241-39
WI
Other
Enumeration date
02/18/2020
Last updated
02/18/2020
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