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Individual

MR. JACOB CHARLES PARENTEAU

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMT

Contact information

Practice address
5401 DOUGLAS AVE, SUITE# A, CALEDONIA, WI 53402
(262) 681-8829
(262) 681-8830
Mailing address
2900 CROSSRIDGE DR, RACINE, WI 53405
(262) 909-8043

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
14809
WI

Other

Enumeration date
02/08/2023
Last updated
02/08/2023
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