Individual
MR. KELSON JAMES WANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, ATC
Contact information
Practice address
285 FOREST GROVE DR STE 207, PEWAUKEE, WI 53072-3738
(877) 732-2262
Mailing address
285 FOREST GROVE DR STE 207, PEWAUKEE, WI 53072-3738
(877) 732-2262
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000010439
—
Other
Enumeration date
02/19/2018
Last updated
02/19/2018
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