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General NPI Number Information
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NPI Number | 1366857112
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Entity Type | Individual
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Provider Name | MELINDA VOET M.S., L.A.T.
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Gender | Female
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Dates
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Enumeration Date | 06/30/2014
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Last Update Date | 02/16/2015
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Provider Practice Location Address
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Address Line | 225 MEMORIAL DR
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City | BERLIN
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State | WI
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Zip | 54923-1243
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Country | US
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Telephone | 920-361-5910
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Fax | 920-361-5536
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Provider Business Mailing Address
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Address Line | 225 MEMORIAL DR
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City | BERLIN
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State | WI
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Zip | 54923-1243
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Country | US
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Telephone | 920-361-5910
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Fax | 920-361-5536
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 1590-39
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License Number State | WI
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