Individual
DANIEL W ZAJICEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
1611 S MADISON ST, APPLETON, WI 54915-1844
(920) 730-6700
Mailing address
1611 S MADISON ST, APPLETON, WI 54915-1844
(920) 730-6700
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
581
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42928200
—
WI
Enumeration date
09/28/2005
Last updated
12/11/2020
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