Individual
JEREMY D. CROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S.P.T.
Contact information
Practice address
725 S WEBSTER AVE, GREEN BAY, WI 54301-3500
(920) 433-7995
(920) 433-3458
Mailing address
PO BOX 22487, GREEN BAY, WI 54305-2487
(920) 445-7210
(920) 445-7289
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10958-024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
027593-1
LICENSCE NUMBER
NY
05
—
36159200
—
WI
01
—
P3663022
OXFORD HEALTHCARE
NY
Enumeration date
01/30/2007
Last updated
02/03/2023
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