Individual
JOURDYN LEIGH KOEBE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
333 PINE RIDGE BLVD, WAUSAU, WI 54401
(715) 847-2160
Mailing address
1811 E 9TH ST, MERRILL, WI 54452-1660
(715) 218-8301
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4400-23
WI
Other
Enumeration date
06/21/2018
Last updated
08/31/2018
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