Individual
JACOB EHLERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
725 W PARK AVE, CHIPPEWA FALLS, WI 54729-3276
(715) 720-2058
Mailing address
3238 DALE RD, EAU CLAIRE, WI 54703-1107
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
4168-026
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40895700
—
WI
Enumeration date
05/21/2007
Last updated
07/08/2007
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