Individual
NICOLE PHEGLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LAT, OTC
Contact information
Practice address
621 SCIENCE DR, MADISON, WI 53711-1074
(908) 752-0592
Mailing address
621 SCIENCE DR, MADISON, WI 53711-1074
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1619
WI
247200000X
Other Technician
14-1116
WI
Other
Enumeration date
01/06/2015
Last updated
02/17/2015
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