Individual
BRITTANY WANDA JAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
10330 PRAIRIE RIDGE BLVD, PLEASANT PRAIRIE, WI 53158-1947
(262) 612-2829
(262) 634-3358
Mailing address
412 OAKHURST AVE, UNION GROVE, WI 53182-1610
(622) 945-9426
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1781-19
WI
Other
Enumeration date
11/21/2011
Last updated
04/23/2024
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