Richard L. Henke, LAT
Specialist/Technologist, Athletic Trainer in Wisconsin Rapids, WI. Individual provider (NPI-1).
NPI number1720060478
StatusActive
Last updated in NPPESFeb 1, 2012
Details
- NPI
- 1720060478
- Entity type
- Individual (NPI-1)
- Name
- Richard L. Henke
- Credential
- LAT
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Nov 17, 2005
- Last updated
- Feb 1, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | 146-39 | WI | Yes |
Practice location
410 Dewey StWisconsin Rapids, WI 54495-8075
Phone 715-421-5257
Mailing address
1000 N Oak AveMarshfield, WI 54449-5703
Phone 715-387-5511
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