Individual
JACOB COUILLARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8700 WATERTOWN PLANK RD, MILWAUKEE, WI 53226-3595
(414) 777-7700
Mailing address
205 4TH ST, GOODMAN, WI 54125-9752
(906) 221-9384
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
05/07/2025
Last updated
05/07/2025
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