Individual
AUSTYN NEALER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1440 MONROE ST, MADISON, WI 53711-2051
(608) 224-9007
Mailing address
301 HARBOUR TOWN DR, #318, MADISON, WI 53717-2110
(720) 412-2660
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1841-39
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1841-39
PROFESSIONAL LICENSE/CREDENTIAL FOR ATHLETIC TRAINING
WI
01
—
2000014527
BOARD OF CERTIFICATION FOR THE ATHLETIC TRAINER
—
Enumeration date
10/06/2016
Last updated
10/06/2016
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