Individual
MRS. JACQUELYN ANN KUBIAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
4111 W MITCHELL ST, MILWAUKEE, WI 53215-1748
(414) 643-3860
Mailing address
4111 W MITCHELL ST, MILWAUKEE, WI 53215-1748
(414) 643-3860
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4777
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100070642
—
WI
Enumeration date
12/02/2016
Last updated
11/18/2022
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