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Individual

JEFFREY HESKIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
3500 TOWER AVE, SUPERIOR, WI 54880
(715) 395-5454
Mailing address
3500 TOWER AVE, SUPERIOR, WI 54880
(715) 395-5454

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10718
WI
225100000X
Physical Therapist
6514
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10718
WI PT LICENSE
WI
01
6514
MN PT LICENSE
MN
Enumeration date
04/17/2007
Last updated
08/27/2008
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