Individual
MATTHEW G JAGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
1650 TRI PARK WAY STE A, APPLETON, WI 54914-1698
(920) 830-6697
(920) 830-6707
Mailing address
1650 TRI PARK WAY STE A, APPLETON, WI 54914-1698
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
002157
IA
225X00000X
Occupational Therapist
104051
MN
225X00000X
Occupational Therapist
Primary
4997-26
WI
Other
Enumeration date
10/01/2011
Last updated
10/01/2011
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