Individual
BRIANNE T JACOBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
818 FOREST LN, WATERFORD, WI 53185-4585
(262) 514-8177
Mailing address
3301 W FOREST HOME AVE, MILWAUKEE, WI 53215-2843
(414) 389-2233
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
13549-24
WI
Other
Enumeration date
12/28/2016
Last updated
12/28/2021
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