Individual
MS. JEAN MARIE NAGRO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
N64W38192 LAC LA BELLE DR, OCONOMOWOC, WI 53066-1653
(262) 370-3380
Mailing address
N64W38192 LAC LA BELLE DR, OCONOMOWOC, WI 53066-1653
(262) 370-3380
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
696019
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40174100
—
WI
Enumeration date
05/06/2008
Last updated
05/14/2008
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