Individual
MICHAEL BAESE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, LAT, ATC
Contact information
Practice address
2901 W KINNICKINNIC RIVER PKWY, SUITE 102, MILWAUKEE, WI 53215-3677
(414) 540-3304
Mailing address
217 GREEN BAY RD, APT C, THIENSVILLE, WI 53092-1651
(314) 681-5927
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2007024550
MO
Other
Enumeration date
07/22/2008
Last updated
09/22/2010
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