Individual
MARK D. JAKUBEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1725 STATE ST, LA CROSSE, WI 54601-3742
(920) 642-0201
Mailing address
1013 STATE ST APT 8, LA CROSSE, WI 54601-3495
(920) 642-0201
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
761-039
WI
Other
Enumeration date
08/14/2006
Last updated
07/08/2007
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