Individual
MRS. JODI ANN MARQUARDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
139 W RAILROAD ST, LENA, WI 54139-0321
(920) 829-5018
Mailing address
139 W RAILROAD ST, PO BOX 321, LENA, WI 54139-0321
(920) 829-5018
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
948-019
WI
Other
Enumeration date
06/03/2008
Last updated
06/03/2008
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