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Ty Wasmuth
NPI 1306228341 · on the registry since 2015
Practice
- Address
- 24138 Blue Heron Dr
Brillion, WI 54110 - Phone
- (920) 901-7843
Registry record
- Primary taxonomy
- Athletic Trainer
2255A2300X
- Licence states on file
- WI
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2015-06-26
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Wisconsin