Individual
MRS. JACELYN ANN MARCINIAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.A.
Contact information
Practice address
1519 60TH ST, KENOSHA, WI 53140-3954
(262) 656-7500
(262) 656-7515
Mailing address
4816 48TH AVE, KENOSHA, WI 53142
(262) 656-7500
(262) 656-7515
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1104-019
WI
Other
Enumeration date
04/15/2010
Last updated
04/15/2010
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