Individual
JESSICA C CARRIVEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
4061 OLD PESHTIGO RD, MARINETTE, WI 54143-3887
(715) 732-8000
Mailing address
N4455 BAGLEY RD, MARINETTE, WI 54143-9625
(715) 789-2463
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5097
WI
Other
Enumeration date
03/12/2007
Last updated
07/08/2007
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