Individual
MRS. ALYSSA MARIE TESSARO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAT
Contact information
Practice address
225 MEMORIAL DR, BERLIN, WI 54923-1243
(920) 361-5534
Mailing address
225 MEMORIAL DR, BERLIN, WI 54923-1243
(920) 361-5534
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1630-39
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1630-39
STATE OF WISCONSIN
WI
Enumeration date
11/18/2015
Last updated
11/18/2015
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