Individual
JADE GAUTHIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1020 HILL ST, WATERTOWN, WI 53098-3016
(920) 261-0400
Mailing address
304 PHEASANT LN, SULLIVAN, WI 53178-9673
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2791-19
WI
Other
Enumeration date
08/06/2026
Last updated
08/06/2026
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