Organization
WAC, INC.
Active
Other names
Wisconsin Athletic Club, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RAYMOND K. O'CONNOR (OWNER)
(414) 328-1300
Entity
Organization
Contact information
Practice address
10840 W ROGERS ST, WEST ALLIS, WI 53227-1135
(414) 328-1300
(414) 328-2640
Mailing address
10840 W ROGERS ST, WEST ALLIS, WI 53227-1135
(414) 328-1300
(414) 328-2640
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
349496800
U.S. DEPT OF LABOR FECA
WI
Enumeration date
01/20/2009
Last updated
01/20/2009
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