Individual
NICHOLAS KRIESEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C, ATC
Contact information
Practice address
N15W28300 GOLF RD, PEWAUKEE, WI 53072-4800
(262) 303-5055
Mailing address
10610 W ROGERS ST, WEST ALLIS, WI 53227-1247
(414) 530-0928
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
AL4910
FL
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
07/14/2017
Last updated
08/17/2022
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