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General NPI Number Information
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NPI Number | 1598891822
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Entity Type | Individual
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Provider Name | ERIN L BUENZLI MS, ATC
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Gender | Female
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Dates
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Enumeration Date | 02/23/2007
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Last Update Date | 12/07/2011
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Provider Practice Location Address
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Address Line | 711 E BOLDT WAY SPC 10
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City | APPLETON
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State | WI
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Zip | 54911-5690
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Country | US
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Telephone | 920-832-7190
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Fax | 920-832-7488
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Provider Business Mailing Address
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Address Line | 711 E BOLDT WAY SPC 10
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City | APPLETON
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State | WI
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Zip | 54911-5690
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Country | US
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Telephone | 920-832-7190
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Fax | 920-832-7488
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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 | 7-039
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License Number State | WI
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