Jesse, Tina
Jesse, Tina is an individual health care provider with primary practice located at 700 N Lake Ave , Twin Lakes WI 53181-9436. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Jesse, Tina can be contacted via phone (262) 877-2124.Contact Information
Primary practice address
700 N Lake Ave
Twin Lakes WI 53181-9436
Phone: (262) 877-2124
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | 6060-024 | Wisconsin |
Profile Details
| NPI number | 1336343342 |
|---|---|
| LBN Legal business name | Jesse, Tina |
| Credentials | Physical Therapist (PT) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 13th, 2007 |
| Last updated | Apr 19th, 2024 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1336343342 | NPPES |
| Wisconsin | MEDICAID | 40365400 |
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