Individual
MRS. JENNIFER L TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
845 SOUTH MAIN STREET, SUITE 120, FOND DU LAC, WI 54935
(920) 322-0447
(920) 322-1362
Mailing address
845 SOUTH MAIN STREET, SUITE 120, FOND DU LAC, WI 54935
(920) 322-0447
(920) 322-1362
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5652-024
WI
225100000X
Physical Therapist
5852-024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40302700
—
WI
Enumeration date
02/17/2007
Last updated
02/23/2010
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