Individual
JEAN M STRAKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
205 PARKER ST, BOSCOBEL, WI 53805-1642
(608) 375-4112
Mailing address
205 PARKER ST, BOSCOBEL, WI 53805-1642
(608) 375-4112
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40372000
—
WI
Enumeration date
09/17/2008
Last updated
09/17/2008
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