Individual
JASON RUSSELL ROE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT,DPT
Contact information
Practice address
900 COLLEGE AVE W, LADYSMITH, WI 54848-2116
(715) 532-5561
Mailing address
900 COLLEGE AVE W, LADYSMITH, WI 54848-2116
(715) 532-5561
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11090-24
WI
Other
Enumeration date
08/12/2008
Last updated
06/26/2013
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