Individual
KYLE REDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT
Contact information
Practice address
1504 MADISON AVE, FORT ATKINSON, WI 53538-3100
(920) 563-9357
Mailing address
1504 MADISON AVE, FORT ATKINSON, WI 53538-1960
(920) 563-9357
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1580-39
WI
Other
Enumeration date
06/10/2014
Last updated
06/10/2014
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