Individual
JASON D'ANTONIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
333 PINE RIDGE BLVD, WAUSAU, WI 54401-4120
(715) 847-2826
Mailing address
PO BOX 1008, WAUSAU, WI 54402-1008
(715) 847-2121
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5529-024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40273400
—
WI
Enumeration date
01/18/2007
Last updated
07/08/2007
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