Individual
JACOB MCCHRYSTAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT, PT
Contact information
Practice address
215 WASHINGTON ST, GRAFTON, WI 53024-1700
(262) 375-3700
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
16003-24
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100259203
—
WI
Enumeration date
12/08/2022
Last updated
08/29/2024
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