Individual
GEORGES WAKIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAT
Contact information
Practice address
3811 SPRING ST., SUITE 102, RACINE, WI 53405
(262) 687-5838
(262) 687-5895
Mailing address
3811 SPRING ST., SUITE 102, RACINE, WI 53405
(262) 687-5838
(262) 687-5895
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1317-39
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1317-39
STATE OF WISCONSIN DEPARTMENT OF SAFETY AND PROFESSIONAL SERVICES
WI
Enumeration date
03/25/2014
Last updated
03/25/2014
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