Individual
NOUTENG LY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1160 KEPLER DR, GREEN BAY, WI 54311-8321
(920) 288-4700
Mailing address
2053 HILLSIDE LN, GREEN BAY, WI 54302-4053
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
11/27/2024
Last updated
11/27/2024
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