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NPI 1326505579

NPI 1326505579 : JORDAN MARIE KRIZAN PT, DPT, AT, ATC : MARSHFIELD, WI

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General NPI Number Information
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    NPI Number           |    1326505579
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    Entity Type          |    Individual 
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    Provider Name        |    JORDAN MARIE KRIZAN PT, DPT, AT, ATC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    02/25/2019
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    Last Update Date     |    02/07/2025
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Provider Practice Location Address
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    Address Line         |    204 N CENTRAL AVE 
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    City                 |    MARSHFIELD
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    State                |    WI
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    Zip                  |    54449-2148
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    Country              |    US
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    Telephone            |    715-898-1600
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    512 W 8TH ST 
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    City                 |    MARSHFIELD
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    State                |    WI
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    Zip                  |    54449-3607
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    Country              |    US
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    Telephone            |    608-396-1013
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    2255A2300X
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    Taxonomy Name        |    Athletic Trainer
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    225100000X
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    Taxonomy Name        |    Physical Therapist
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    License Number       |    
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    License Number State |    
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