Healthcare Provider Details

I. General information

NPI: 1912170366
Provider Name (Legal Business Name): BARBARA JEAN JERMYN PT, ATP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/07/2008
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2448 S 102ND ST STE 340
MILWAUKEE WI
53227-2147
US

IV. Provider business mailing address

8867 GREENVIEW LN
GREENDALE WI
53129-1552
US

V. Phone/Fax

Practice location:
  • Phone: 414-329-2500
  • Fax:
Mailing address:
  • Phone: 414-732-0320
  • Fax: 262-966-3501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2856-024
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: