Individual
MR. ZACHARY FUCIK FAHRENKRUG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, LAT, CSCS
Contact information
Practice address
220 KELLER AVE N, AMERY, WI 54001-1036
(715) 268-1008
Mailing address
207 JADEN DR, MILLTOWN, WI 54858-9075
(920) 460-2208
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1603
WI
Other
Enumeration date
03/29/2018
Last updated
03/29/2018
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