Healthcare Provider Details

I. General information

NPI: 1033179197
Provider Name (Legal Business Name): JOLENE DORIS STRIFLER ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JOLENE DORIS ATKINS ATC

II. Dates (important events)

Enumeration Date: 03/24/2006
Last Update Date: 12/20/2019
Certification Date: 12/20/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

621 SCIENCE DRIVE
MADISON WI
53711
US

IV. Provider business mailing address

621 SCIENCE DRIVE
MADISON WI
53711
US

V. Phone/Fax

Practice location:
  • Phone: 608-890-7500
  • Fax:
Mailing address:
  • Phone: 608-890-7500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number695-039
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: