Individual
MRS. JULIE MARIE HALVORSEN-JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
2300 STATE ROAD 44, OSHKOSH, WI 54904-9137
(920) 233-2372
Mailing address
W4264 KIEKHAEFER PKWY, FOND DU LAC, WI 54935-6801
(920) 922-4116
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
3278-024
WI
Other
Enumeration date
08/30/2006
Last updated
07/08/2007
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