Individual
JONATHAN ELMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
821 E 1ST AVE STE 2LL, APPLETON, WI 54911-1586
(920) 284-9952
Mailing address
2400 S KENSINGTON DR STE 400, APPLETON, WI 54915-4187
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
7952125
WI
Other
Enumeration date
12/01/2020
Last updated
10/10/2022
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