Individual
ELLA CAIT HUSOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4602 EASTPARK BLVD, MADISON, WI 53718-2002
(608) 712-7808
Mailing address
706 N STAR DR, MADISON, WI 53718-3070
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1065-39
WI
Other
Enumeration date
08/21/2019
Last updated
08/21/2019
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