Individual
JESSICA GAIL LOIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
830B E GENEVA ST, DELAVAN, WI 53115-1932
(262) 728-9164
(262) 728-9172
Mailing address
830B E GENEVA ST, DELAVAN, WI 53115-1932
(262) 728-9164
(262) 728-9172
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2672-19
WI
Other
Enumeration date
11/13/2017
Last updated
11/13/2017
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