Provider Demographics
NPI:1447528724
Name:WURZEL, JESSICA LYNN (PTA)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:LYNN
Last Name:WURZEL
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2448 S 102ND ST
Mailing Address - Street 2:SUITE 250
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53227-2466
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:902 GARLAND ST E
Practice Address - Street 2:
Practice Address - City:WEST SALEM
Practice Address - State:WI
Practice Address - Zip Code:54669-1308
Practice Address - Country:US
Practice Address - Phone:608-786-1400
Practice Address - Fax:608-786-1419
Is Sole Proprietor?:No
Enumeration Date:2011-12-01
Last Update Date:2011-12-01
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant