Individual
MRS. JESSICA L BOSQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
103 S PIONEER RD, FOND DU LAC, WI 54935-3871
(920) 922-7776
Mailing address
103 S PIONEER RD, FOND DU LAC, WI 54935-3871
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10845-024
WI
Other
Enumeration date
07/02/2007
Last updated
08/15/2016
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