Individual
MRS. LORI JO DAUSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, ATC, LAT
Contact information
Practice address
1700 W PARADISE DR, WEST BEND, WI 53095-9795
(262) 836-2404
Mailing address
2020 TERRY RD, HARTFORD, WI 53027-9725
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
395-39
WI
Other
Enumeration date
01/02/2019
Last updated
01/02/2019
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