NPI 1962916395

Ryan Christopher Jolly, ATCEMTB

Practitioner Basic Emergency Medical Technician Lake Geneva, WI

Practice location

Address: N1457 Hillside Rd, Lake Geneva, WI 53147-4235
Phone: (262) 248-4103
Mailing address: 1028 S Lake Shore Dr, Lake Geneva, WI 53147-2235

Registered specialties (2)

Basic Emergency Medical Technician Primary

Emergency Medical Service Providers Taxonomy 146N00000X Licence 70108769 (WI)

Other Emergency Medical Technician, Basic providers in Wisconsin →

Athletic Trainer

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X

Other Specialist/Technologist providers in Wisconsin →

Registry record

NPI: 1962916395
Entity type: Individual
Sex (as registered): Male
NPI issued: 21 Nov 2017
Record last updated: 21 Nov 2017

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.