Maciolek, Jennifer L

Maciolek, Jennifer L is an individual health care provider with primary practice located at N112W17975 Mequon Rd , Germantown WI 53022-2425. 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. Maciolek, Jennifer L can be contacted via phone (262) 532-7600.

Contact Information

Primary practice address
N112W17975 Mequon Rd Germantown WI 53022-2425
Phone: (262) 532-7600
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 4159 Wisconsin

Profile Details

NPI number 1740314699
LBN Legal business name Maciolek, Jennifer L
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 15th, 2007
Last updated Dec 8th, 2021 - about 5 years ago

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1740314699 NPPES
Wisconsin MEDICAID 40382500

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