Provider Demographics
NPI:1245620566
Name:AHRENS, JUSTIN (ATC)
Entity type:Individual
Prefix:
First Name:JUSTIN
Middle Name:
Last Name:AHRENS
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1310 S WESTCHESTER ST
Mailing Address - Street 2:
Mailing Address - City:WEST MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53214-3648
Mailing Address - Country:US
Mailing Address - Phone:608-295-2583
Mailing Address - Fax:
Practice Address - Street 1:1701 27TH ST E
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34208-7831
Practice Address - Country:US
Practice Address - Phone:412-403-3445
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-26
Last Update Date:2015-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer