Provider Demographics
NPI:1922508290
Name:STRASSER, KELLY ANN (CSCS)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:ANN
Last Name:STRASSER
Suffix:
Gender:F
Credentials:CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1657 RIDGE ST
Mailing Address - Street 2:
Mailing Address - City:NIAGARA
Mailing Address - State:WI
Mailing Address - Zip Code:54151-1535
Mailing Address - Country:US
Mailing Address - Phone:906-396-1046
Mailing Address - Fax:
Practice Address - Street 1:1657 RIDGE ST
Practice Address - Street 2:
Practice Address - City:NIAGARA
Practice Address - State:WI
Practice Address - Zip Code:54151-1535
Practice Address - Country:US
Practice Address - Phone:906-396-1046
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-13
Last Update Date:2018-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer