Individual
NATHAN MARESH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT
Contact information
Practice address
557 N WASHINGTON ST, JANESVILLE, WI 53548-2907
(608) 754-6000
Mailing address
557 N WASHINGTON ST, JANESVILLE, WI 53548-2907
(608) 754-6000
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
987-039
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
987-039
LICENSE
WI
Enumeration date
10/08/2008
Last updated
10/08/2008
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