NPI 1649725938

Tia Jackson, MSLATATC

Practitioner Athletic Trainer Sturgeon Bay, WI

Practice location

Address: 323 S 18th Ave, Sturgeon Bay, WI 54235-1401
Phone: (920) 746-0410

Registered specialties

Athletic Trainer Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X Licence 1559-39 (WI)

Other Specialist/Technologist providers in Wisconsin →

Registry record

NPI: 1649725938
Entity type: Individual
Sex (as registered): Female
NPI issued: 17 Aug 2016
Record last updated: 19 Feb 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.