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Individual

JORDAN CERVENKA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3540 S 43RD ST, MILWAUKEE, WI 53220-1502
(414) 328-2128
Mailing address
3540 S 43RD ST, MILWAUKEE, WI 53220-1502

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
4942-27
WI
225X00000X
Occupational Therapist
Primary
6764
WI

Other

Enumeration date
08/18/2015
Last updated
12/14/2022
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