Individual
MR. JACOB R. DINAUER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MED, ATC, EMT
Contact information
Practice address
2001 ALFORD PARK DR, TARC 1150, KENOSHA, WI 53140-1929
(262) 551-6107
(262) 551-5995
Mailing address
3526 W 7 MILE RD, CALEDONIA, WI 53108-9749
(262) 939-6560
(262) 551-5995
Taxonomy
Speciality
Code
Description
License number
State
146M00000X
Intermediate Emergency Medical Technician
Primary
304299
WI
2255A2300X
Athletic Trainer
103-039
WI
Other
Enumeration date
04/06/2006
Last updated
09/11/2025
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