Greg Ehlers, EDD, LAT

Individual provider Active NPI Athletic Trainer · Cedarburg, WI

NPI 1417596172 · NPPES record last updated Dec 29, 2019

Key facts

NPI
1417596172
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
Practice address
W51N215 Fillmore Ave
Cedarburg, WI 53012-2939
Phone
(414) 690-0874
NPI assigned
Dec 29, 2019
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X Yes

Addresses

Primary practice location

W51N215 Fillmore Ave
Cedarburg, WI 53012-2939

Mailing address

W51N215 Fillmore Ave
Cedarburg, WI 53012-2939
Phone (414) 690-0874

Other providers in Cedarburg, WI

All providers in Cedarburg, WI · Athletic Trainer in Wisconsin

Sources for this page

Verify at the official NPI Registry.