Individual
BRIAN L JAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
200 E RYAN RD, OAK CREEK, WI 53154-4563
(414) 570-4330
(414) 570-7331
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1524-023
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41977500
—
WI
Enumeration date
07/10/2006
Last updated
08/05/2025
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