Individual
JONATHAN PURVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAT
Contact information
Practice address
2116 CRAIG RD, EAU CLAIRE, WI 54701-6149
(715) 858-4500
Mailing address
2116 CRAIG RD, EAU CLAIRE, WI 54701-6149
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
075019
IA
Other
Enumeration date
01/22/2015
Last updated
07/29/2016
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