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Organization
PETER JOHN JACQUES
Active
Organization
PETER JOHN JACQUES
Active
Other names
Walking and Wheeling LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PETER JOHN JACQUES PT (OWNER CEO)
(920) 540-8840
Entity
Organization
Contact information
Practice address
W4652 GLENN ST, APPLETON, WI 54913-9563
(920) 540-8840
(866) 878-1996
Mailing address
W4652 GLENN ST, APPLETON, WI 54913-9563
(920) 540-8840
(866) 878-1996
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3448024
WI
332BC3200X
Customized Equipment (DME)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41750700
—
WI
Enumeration date
09/18/2007
Last updated
01/30/2013
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