Individual
MRS. JESSICA DUFAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT, ATC
Contact information
Practice address
305 S LIVINGSTON ST, MADISON, WI 53703-3513
(608) 512-3769
Mailing address
305 S LIVINGSTON ST, MADISON, WI 53703-3513
(608) 512-3769
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11909-24
WI
225100000X
Physical Therapist
5232
OR
Other
Enumeration date
08/19/2006
Last updated
02/25/2012
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