Jeffrey Allen Cieslak, LAT,AT,C, EMT
Specialist/Technologist, Athletic Trainer in Glendale, WI. Individual provider (NPI-1).
NPI number1457740979
StatusActive
Last updated in NPPESJan 21, 2015
Details
- NPI
- 1457740979
- Entity type
- Individual (NPI-1)
- Name
- Mr. Jeffrey Allen Cieslak
- Credential
- LAT,AT,C, EMT
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jan 21, 2015
- Last updated
- Jan 21, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | 0000195-039 | WI | Yes |
Practice location
400 W Riverwoods PkwyGlendale, WI 53212
Phone 414-465-3000
Mailing address
34565 Meadow View CtOconomowoc, WI 53066-8778
Phone 262-853-1629
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