Avery Bannan

NPI #1871961474 in Sauk City, Wisconsin

Provider Information

NPI Number: 1871961474
Entity Type: Individual
Name: Avery Bannan
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Student in an Organized Health Care Education/Training Program
Enumeration Date: Sep 13, 2015
Last Updated: Sep 13, 2015

Practice Location

Address: E10931 STATE ROAD 60
City: Sauk City
State: Wisconsin
ZIP Code: 53583-9607
Phone: (608) 370-2711

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist/Technologist - Athletic Trainer — Athletic Trainer	2255A2300X
Student in an Organized Health Care Education/Training Program	390200000X	Primary

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