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Individual

JACOB JON DESANTIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
16 W JOHN ST STE 3, RICE LAKE, WI 54868-2918
(715) 205-5564
Mailing address
16 W JOHN ST STE 3, RICE LAKE, WI 54868-2918
(715) 205-5564

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5417
WI

Other

Enumeration date
11/01/2018
Last updated
04/18/2026
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