Individual
JENNIFER J STRUC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
10400 75TH STREET, KENOSHA, WI 53142
(262) 948-7045
Mailing address
10400 75TH ST, KENOSHA, WI 53142-7884
(262) 948-7045
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1217
WI
Other
Enumeration date
05/21/2008
Last updated
11/30/2010
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