Individual
MR. JACOB JOHN GRICAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT, LAT
Contact information
Practice address
13250 WASHINGTON AVE, MOUNT PLEASANT, WI 53177-1516
(262) 799-8330
(262) 799-8331
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2550
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
17322-24
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100366844
—
WI
Enumeration date
03/25/2021
Last updated
08/06/2025
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