Individual
DEANNE YVONNE JACOBSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.P.T.
Contact information
Practice address
2727 N GRANDVIEW BLVD, WAUKESHA, WI 53188-6100
(414) 333-1953
Mailing address
2727 N GRANDVIEW BLVD, WAUKESHA, WI 53188-6100
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6111-024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40385600
—
WI
Enumeration date
10/10/2006
Last updated
06/08/2016
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