Individual
JACOB STARKWEATHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MASSAGE THERAPIST
Contact information
Practice address
5170 S 76TH ST STE 107, GREENDALE, WI 53129-1112
(414) 482-5170
Mailing address
1515 CAMDEN CT UNIT D, WAUKESHA, WI 53186-6867
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
WI
Other
Enumeration date
10/02/2021
Last updated
10/02/2021
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