Individual
MRS. KRYSTAL K JECEVICUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.A.
Contact information
Practice address
3415 SHERIDAN RD, KENOSHA, WI 53140-1924
(262) 653-2940
(262) 657-6681
Mailing address
3415 SHERIDAN RD, KENOSHA, WI 53140-1924
(262) 653-2940
(262) 657-6681
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1549-19
WI
Other
Enumeration date
09/10/2012
Last updated
09/10/2012
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