Individual
DANIEL JACOBSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3200 S 20TH ST, MILWAUKEE, WI 53215-4442
(414) 389-3200
Mailing address
N103W17546 WHITETAIL RUN, GERMANTOWN, WI 53022-4691
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
06/24/2019
Last updated
06/24/2019
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