Individual
ANNA MIELKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAT, ATC
Contact information
Practice address
1650 S 41ST ST, MANITOWOC, WI 54220-7316
(920) 320-3139
Mailing address
1650 S 41ST ST, MANITOWOC, WI 54220-7316
(920) 320-3139
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1458-39
WI
Other
Enumeration date
09/10/2014
Last updated
10/01/2015
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