Individual
JACOB R BIRDSALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D-PT
Contact information
Practice address
2809 N PARK DRIVE LN, APPLETON, WI 54911-1603
(920) 830-4999
(920) 380-4961
Mailing address
2809 N PARK DRIVE LN, APPLETON, WI 54911-1603
(920) 380-4999
(920) 380-4961
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
13915-24
WI
Other
Enumeration date
07/26/2017
Last updated
04/27/2023
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