Individual
MS. MELISSA WAYTASHEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LAT, ATC
Contact information
Practice address
100 BECKER ST, TURTLE LAKE, WI 54889-9205
(715) 263-4103
Mailing address
224 50TH AVE, CLAYTON, WI 54004-3508
(320) 360-6189
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1412-39
WI
Other
Enumeration date
07/17/2014
Last updated
07/17/2014
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