Individual
JENNIFER DHANWANTRI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2222 S 114TH ST, WEST ALLIS, WI 53227-1031
(414) 449-4444
Mailing address
N41W22829 SUNDER CREEK DR, PEWAUKEE, WI 53072-2267
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2254000000X
ESSWI
WI
Enumeration date
02/05/2014
Last updated
02/05/2014
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