Individual
ALLAN WOLLENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1330 214TH AVE, NEW RICHMOND, WI 54017-1068
(715) 410-7294
Mailing address
1330 214TH AVE, NEW RICHMOND, WI 54017-1068
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11811166
HEALTH PARTNERS
—
Enumeration date
04/09/2018
Last updated
04/09/2018
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