Wade Christian Peitersen, LAT
Specialist/Technologist, Athletic Trainer in Oshkosh, WI. Individual provider (NPI-1).
NPI number1154476141
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1154476141
- Entity type
- Individual (NPI-1)
- Name
- Mr. Wade Christian Peitersen
- Credential
- LAT
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jan 23, 2007
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | 125-039 | WI | Yes |
Practice location
800 Algoma BlvdKolf Sports Center 169l
Oshkosh, WI 54901-3551
Phone 920-424-7138 · Fax 920-424-1068
Mailing address
800 Algoma BlvdKolf Sports Center 169l
Oshkosh, WI 54901-3551
Phone 920-424-7138 · Fax 920-424-1068
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All 33 Athletic Trainer providers in Oshkosh · All 1,890 providers in Oshkosh
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