Podolak, Jessica J

Podolak, Jessica J is an individual health care provider with primary practice located at 224 N Bridge St Suite B, Chippewa Falls WI 54729-2405. 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. Podolak, Jessica J can be contacted via phone (715) 723-4451.

Contact Information

Primary practice address
224 N Bridge St Suite B Chippewa Falls WI 54729-2405
Phone: (715) 723-4451
Fax: (715) 723-5712
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 6039-024 Wisconsin

Profile Details

NPI number 1902898372
LBN Legal business name Podolak, Jessica J
Credentials Master of Physical Therapy (MPT)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 22nd, 2005
Last updated Nov 4th, 2014 - about 11 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 1902898372 NPPES
Wisconsin MEDICAID 40373700

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