NPI 1326697400

Wyatt Henkenius, LATATC

Practitioner Athletic Trainer Pewaukee, WI

Practice location

Address: 285 Forest Grove Dr, Pewaukee, WI 53072-3782
Phone: (641) 745-9378
Mailing address: 1076 Jasper Dr, West Des Moines, IA 50266-3312

Registered specialties

Athletic Trainer Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X Licence 083438 (IA)

Other Specialist/Technologist providers in Wisconsin →

Registry record

NPI: 1326697400
Entity type: Individual
Sex (as registered): Male
NPI issued: 10 Sep 2019
Record last updated: 10 Sep 2019

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.