Individual
ALFREDO JAQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
370 W ANCHOR DR STE 214, DAKOTA DUNES, SD 57049-5153
(605) 360-4697
Mailing address
321 E 34TH ST, SOUTH SIOUX CITY, NE 68776-3532
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2036
NE
Other
Enumeration date
12/04/2023
Last updated
12/04/2023
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