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1053577825
SHAWN E JACKSON
GREEN BAY, WI
NPI
1053577825
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225100000X Physical Therapist
(Licence: WI #4899-024)
Enumeration Date
2008-07-31
Last Update Date
2015-05-21
Business Address
Mr. SHAWN E JACKSON P.T.
2701 LARSEN RD SUITE 111
GREEN BAY, WI 54303-4863
Phone number: 920-883-2284
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Mailing Address
Mr. SHAWN E JACKSON P.T.
2701 LARSEN RD SUITE 111
GREEN BAY, WI 54303-4863
Phone number: 920-883-2284
Copy
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