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Cody Scott Tesch, ATC/LAT

Specialist/Technologist, Athletic Trainer in Milwaukee, WI. Individual provider (NPI-1).

NPI number1124649751
StatusActive
Last updated in NPPESMay 5, 2020

Details

NPI
1124649751
Entity type
Individual (NPI-1)
Name
Cody Scott Tesch
Credential
ATC/LAT
Sex
Male
Sole proprietor
Yes
Enumeration date
May 5, 2020
Certification date
May 5, 2020
Last updated
May 5, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2255A2300X Specialist/Technologist, Athletic TrainerBOC312660WIYes

Practice location

6680 N Teutonia Ave
Milwaukee, WI 53209-3117

Phone 414-758-3300

Mailing address

6680 N Teutonia Ave
Milwaukee, WI 53209-3117

Phone 414-758-3300

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