Individual
JACOB PELOQUIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
1311 TYLER ST, BLACK RIVER FALLS, WI 54615-1564
(608) 498-6021
Mailing address
1311 TYLER ST, BLACK RIVER FALLS, WI 54615-1564
(608) 498-6021
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
4416
WI
Other
Enumeration date
04/30/2009
Last updated
08/28/2023
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