Samantha Rose Jacoby, PTA
Physical Therapy Assistant in Mayville, WI. Individual provider (NPI-1).
NPI number1780187088
StatusActive
Last updated in NPPESMar 13, 2018
Details
- NPI
- 1780187088
- Entity type
- Individual (NPI-1)
- Name
- Samantha Rose Jacoby
- Credential
- PTA
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 13, 2018
- Last updated
- Mar 13, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225200000X | Physical Therapy Assistant | – | – | Yes |
Practice location
305 S Clark StMayville, WI 53050-1488
Phone 920-387-0354
Mailing address
5580 Jacqueline DrWest Bend, WI 53095-9728
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
Other Physical Therapy Assistant providers in Mayville, WI
- Daniel FrenetteNPI 1134564628
- Sheena RichmondNPI 1952648537
- Darla Lynne Schultz, PTANPI 1467674242
- Sara Wagner, PTANPI 1144765652
- Robin Marie Wankowski, PTANPI 1134332679
All 6 Physical Therapy Assistant providers in Mayville · All 91 providers in Mayville
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