Individual
JACOB ANASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
2502 S ASHLAND AVE, GREEN BAY, WI 54304-5252
(920) 496-4700
Mailing address
1128 RAINETTA DR, EAU CLAIRE, WI 54701-9337
(715) 271-2441
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
15167
WI
Other
Enumeration date
12/17/2020
Last updated
12/17/2020
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