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General NPI Number Information
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NPI Number | 1841607884
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Entity Type | Individual
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Provider Name | KARLYE CLAUSEN ATC
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Gender | Female
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Dates
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Enumeration Date | 07/22/2014
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Last Update Date | 05/19/2022
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Provider Practice Location Address
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Address Line | 700 COLLEGE ST
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City | BELOIT
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State | WI
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Zip | 53511-5595
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Country | US
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Telephone | 715-577-3065
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Fax |
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Provider Business Mailing Address
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Address Line | 2747 PARK PLACE LN APT 13
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City | JANESVILLE
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State | WI
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Zip | 53545-5235
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Country | US
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Telephone | 715-577-3065
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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 | 2452-39
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State | MN
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