JACKIE CHURCH

EDGERTON, WI
NPI1104029362
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: WI  783-019)
Enumeration Date2007-06-06
Last Update Date2007-07-08
Business Address
-- JACKIE CHURCH
313 STOUGHTON RD
EDGERTON, WI 53534-1132
Phone number: 608-884-1390
Mailing Address
-- JACKIE CHURCH
313 STOUGHTON RD
EDGERTON, WI 53534-1132
Phone number: 608-884-1390
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