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Individual

JESSICA L KING

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.T.

Contact information

Practice address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Mailing address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10243
WI
225100000X
Physical Therapist
7361
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
046663800
MN
Enumeration date
01/27/2006
Last updated
04/11/2016
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