Individual
MR. JEFFREY BRIAN MAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
121 HOSPITAL DR, WATERTOWN, WI 53098-3303
(920) 392-1102
(479) 201-0257
Mailing address
440 WELLS ST STE 200, DELAFIELD, WI 53018-1412
(920) 392-1102
(479) 201-0257
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4686-024
WI
Other
Enumeration date
04/21/2008
Last updated
04/21/2008
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