Individual
TRACI VANDERLOOP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAT
Contact information
Practice address
333 ALBERT WAY, APPLETON, WI 54915-6426
(920) 422-0961
Mailing address
333 ALBERT WAY, APPLETON, WI 54915-6426
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1373-39
WI
Other
Enumeration date
01/05/2023
Last updated
01/05/2023
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