Individual
JENNIFER LYNN MAGESTRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
12555 W NATIONAL AVE, NEW BERLIN, WI 53151-4061
(414) 550-1268
Mailing address
8206 N REGENT RD, FOX POINT, WI 53217-2734
(414) 550-1268
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5205-024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40337600
—
WI
Enumeration date
06/03/2006
Last updated
06/27/2008
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