Individual
MATTISON MARIE MCWHERTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2901 W KINNICKINNIC RIVER PKWY STE 102, MILWAUKEE, WI 53215-3660
(414) 646-8000
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
363A00000X
Physician Assistant
Primary
8009-23
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100296939
—
WI
Enumeration date
02/20/2019
Last updated
12/16/2024
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