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1225057912
JEROME G. CHARLES
GREEN BAY, WI
NPI
1225057912
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: WI 2921-024)
Enumeration Date
2006-07-19
Last Update Date
2013-06-25
Business Address
-- JEROME G. CHARLES PT
211 N BROADWAY STE 105
GREEN BAY, WI 54303-2757
Phone number: 920-432-9040
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Mailing Address
-- JEROME G. CHARLES PT
4000 N PROVIDENCE AVE
APPLETON, WI 54913-8018
Phone number: 920-257-2005
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