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Individual
JENNIFER K GAGNON
Active
Individual
JENNIFER K GAGNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
070.026066
IL
225100000X
Physical Therapist
Primary
16115
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100230064
—
WI
Enumeration date
09/16/2021
Last updated
10/03/2024
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