Individual
MR. JESSE L NEWELL JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
12800 N LAKE SHORE DR, MEQUON, WI 53097-2418
(262) 243-2641
(262) 243-2969
Mailing address
835 N CASS ST APT 31, MILWAUKEE, WI 53202-3929
(651) 239-3147
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1506-39
WI
Other
Enumeration date
01/28/2015
Last updated
01/28/2015
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