Individual
JACOB DYLAN THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
17040 W GREENFIELD AVE STE 6, BROOKFIELD, WI 53005-6844
(262) 439-8019
(262) 289-9310
Mailing address
17040 W GREENFIELD AVE STE 6, BROOKFIELD, WI 53005-6844
(262) 439-8019
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
11249
WI
Other
Enumeration date
02/24/2021
Last updated
02/24/2021
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