Individual
MS. JODI CAROL HOUGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1626 N SPRING ST, SUITE B, BEAVER DAM, WI 53916-1283
(920) 356-0122
(920) 356-0470
Mailing address
1626 N SPRING ST, SUITE B, BEAVER DAM, WI 53916-1283
(920) 356-0122
(920) 356-0470
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1597-19
WI
Other
Enumeration date
01/27/2011
Last updated
03/13/2015
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