Individual
MICHELLE ELAINE DEROME
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5310 S NICOLET DR, NEW BERLIN, WI 53151-8252
(262) 226-6049
Mailing address
5310 S NICOLET DR, NEW BERLIN, WI 53151-8252
(262) 226-6049
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
02/17/2025
Last updated
02/17/2025
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