Individual
JENNIFER LYNN KELLERHUIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MED, LAT, ATC
Contact information
Practice address
4401 WHITETAIL LN, MADISON, WI 53704-8101
(608) 669-8242
Mailing address
4401 WHITETAIL LN, MADISON, WI 53704-8101
(608) 669-8242
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
39-1618
WI
Other
Enumeration date
12/03/2014
Last updated
12/03/2014
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