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Individual

MS. JENNIFER T LEAVENS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
5404 W LOOMIS RD, GREENDALE, WI 53129-1411
(414) 421-0088
Mailing address
515 MACKINAC AVE, SOUTH MILWAUKEE, WI 53172-3321
(414) 762-5192

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
382-019
WI

Other

Enumeration date
05/07/2008
Last updated
05/07/2008
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