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General NPI Number Information
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NPI Number | 1588046635
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Entity Type | Individual
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Provider Name | CASEY ANN HAMILL-BARTH LAT
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Gender | Female
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Dates
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Enumeration Date | 06/25/2015
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Last Update Date | 06/25/2015
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Provider Practice Location Address
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Address Line | 1190 E PARADISE DR
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City | WEST BEND
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State | WI
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Zip | 53095-5444
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Country | US
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Telephone | 262-306-6319
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Fax |
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Provider Business Mailing Address
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Address Line | 2305 SPRINGBROOK N
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City | WAUKESHA
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State | WI
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Zip | 53186-1242
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Country | US
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Telephone | 262-366-2741
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Fax |
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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 | 1626-39
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License Number State | WI
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