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Individual

JACOB JODAT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
10625 W NORTH AVE STE 101B, WAUWATOSA, WI 53226-2315
(414) 877-5350
Mailing address
854 DELAWARE AVE APT C, GRAFTON, WI 53024-9479
(262) 951-1750

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
WI

Other

Enumeration date
07/29/2022
Last updated
07/29/2022
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