Individual
DANIEL DEAN JESKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
124 PETERSEN PARKWAY #1, THAYNE, WY 83127
(307) 883-7878
Mailing address
124 PETERSEN PARKWAY #4, THAYNE, WY 83127
(307) 883-7878
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
WY-948
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
117016300
—
WY
Enumeration date
07/20/2006
Last updated
05/09/2017
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