Provider Demographics
NPI:1447963442
Name:JONAS, PATRICK LANE
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:LANE
Last Name:JONAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1750 RIVER OAKS CT
Mailing Address - Street 2:
Mailing Address - City:KRONENWETTER
Mailing Address - State:WI
Mailing Address - Zip Code:54455-7928
Mailing Address - Country:US
Mailing Address - Phone:715-803-3349
Mailing Address - Fax:
Practice Address - Street 1:225000 HUMMINGBIRD RD
Practice Address - Street 2:
Practice Address - City:WAUSAU
Practice Address - State:WI
Practice Address - Zip Code:54401-2948
Practice Address - Country:US
Practice Address - Phone:715-359-6442
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-04
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant