Individual
MR. ROSS TIMOTHY KOEHLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1900 W SUMNER ST, HARTFORD, WI 53027
(262) 673-1261
(262) 673-1644
Mailing address
555 S. 108TH STREET, WEST ALLIS, WI 53214
(414) 566-3803
(414) 566-3866
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1024-039
WI
Other
Enumeration date
09/10/2009
Last updated
12/01/2010
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