Individual
MR. JACOB ANDREW SOBCZAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
6263 N GREEN BAY AVE, MILWAUKEE, WI 53209-3823
(414) 351-0543
Mailing address
6263 N GREEN BAY AVE, MILWAUKEE, WI 53209-3823
(414) 351-0543
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
4988-27
WI
Other
Enumeration date
06/21/2013
Last updated
06/21/2013
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