Individual
ANNA NIEMUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAT
Contact information
Practice address
8700 W WATERTOWN PLANK RD, MILWAUKEE, WI 53226-3595
(414) 805-7100
Mailing address
N78W22914 N COLDWATER CIR, SUSSEX, WI 53089-1576
(262) 237-7494
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1824-39
WI
Other
Enumeration date
06/21/2021
Last updated
06/21/2021
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