Individual
MS. JEANETTE ELIZABETH CAMPAGNOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2727 W MITCHELL ST, MILWAUKEE, WI 53215-2259
(141) 383-3699
(414) 383-3866
Mailing address
4529 S GRIFFIN AVE, MILWAUKEE, WI 53207-5863
(414) 481-4269
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
940-019
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40207300
—
WI
Enumeration date
05/10/2007
Last updated
07/08/2007
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