Individual
JEROLD ELSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
231 WALNUT ST, SPOONER, WI 54801-1322
(712) 635-9791
Mailing address
921 SCRIBNER ST, SPOONER, WI 54801-1196
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
5072-146
WI
Other
Enumeration date
01/10/2016
Last updated
01/10/2016
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