Brett Jensen, LAT, ATC

Individual provider Active NPI Athletic Trainer · Baldwin, WI

NPI 1508425356 · NPPES record last updated Aug 21, 2020

Key facts

NPI
1508425356
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
License
1318-39 (WI)
Practice address
1100 Bergslien St
Baldwin, WI 54002-2600
Phone
(715) 684-1505
NPI assigned
Jun 6, 2019
Sex
Male
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
1318-39WIMDAthletic Trainer

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 1318-39 WI Yes

Addresses

Primary practice location

1100 Bergslien St
Baldwin, WI 54002-2600

Mailing address

702 E Grant Ave
Eau Claire, WI 54701-6488

Other practice location 1

1309 Stout Rd
Menomonie, WI 54751-2959
Phone (715) 829-4224

Other practice location 2

517 E Clairemont Ave
Eau Claire, WI 54701-6479
Phone (715) 829-4224

Other providers in Baldwin, WI

All providers in Baldwin, WI · Athletic Trainer in Wisconsin

Sources for this page

Verify at the official NPI Registry.