Individual
MICHAEL MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAT ATC
Contact information
Practice address
1 UNIVERSITY PLZ, PLATTEVILLE, WI 53818-3001
(608) 342-6015
Mailing address
1 UNIVERSITY PLZ, PLATTEVILLE, WI 53818-3001
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1663-39
WI
Other
Enumeration date
09/24/2020
Last updated
09/24/2020
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