Individual
MR. JEFFREY S JETER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
2105 E ENTERPRISE AVE # 113, ADVANCED PHYSICAL THERAPY, APPLETON, WI 54913-7862
(920) 991-2561
(920) 991-2563
Mailing address
2105 E ENTERPRISE AVE # 113, ADVANCED PHYSICAL THERAPY, APPLETON, WI 54913-7862
(920) 991-2561
(920) 991-2563
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4557
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40357800
—
WI
Enumeration date
08/12/2005
Last updated
07/18/2008
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