Individual
MEGHAN LANGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1612 ROYAL CROWN CT, GREEN BAY, WI 54313-4390
(920) 639-6762
Mailing address
1612 ROYAL CROWN CT, GREEN BAY, WI 54313-4390
(920) 639-6762
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/09/2017
Last updated
03/09/2017
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