Jeremy Amundson, LAT, ATC

Individual provider Active NPI Athletic Trainer · Eau Claire, WI

NPI 1952789786 · NPPES record last updated Feb 27, 2019

Key facts

NPI
1952789786
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
License
1959-39 (WI)
Practice address
1400 Bellinger St
Eau Claire, WI 54703
Phone
(715) 838-6161
NPI assigned
May 13, 2015
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
1959-39WIMDAthletic Trainer

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 1959-39 WI Yes

Addresses

Primary practice location

1400 Bellinger St
Eau Claire, WI 54703

Mailing address

8929 23Rd Ave S
Eau Claire, WI 54703-0182
Phone (715) 417-2165

Other practice location 1

1612 Eddy Ln
Eau Claire, WI 54703-0803
Phone (715) 417-2165

Other providers in Eau Claire, WI

All providers in Eau Claire, WI · Athletic Trainer in Wisconsin

Sources for this page

Verify at the official NPI Registry.