# JENNIFER J WALLSKOG

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1164599395
- **Gender:** F
- **Credential:** PT

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 3333 | WI | Yes |
| 2251X0800X | Orthopedic Physical Therapist | 3333 | WI | — |

## Other

- **Enumeration date:** 11/30/2006
- **Last updated:** 01/02/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 36113600 | — | WI |