NPI 1154476141

Wade Christian Peitersen, LAT

Practitioner Athletic Trainer Oshkosh, WI

Practice location

Address: 800 Algoma Blvd Kolf Sports Center 169l, Oshkosh, WI 54901-3551
Phone: (920) 424-7138
Fax: (920) 424-1068

Registered specialties

Athletic Trainer Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X Licence 125-039 (WI)

Other Specialist/Technologist providers in Wisconsin →

Registry record

NPI: 1154476141
Entity type: Individual
Sex (as registered): Male
NPI issued: 23 Jan 2007
Record last updated: 8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.