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General NPI Number Information
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NPI Number | 1619098894
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Entity Type | Individual
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Provider Name | JOCELYN MARIE OSBORNE DPT
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Gender | Female
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Dates
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Enumeration Date | 04/03/2007
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Last Update Date | 06/24/2011
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Provider Practice Location Address
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Address Line | 237 E MAIN ST
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City | TWIN LAKES
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State | WI
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Zip | 53181-9681
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Country | US
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Telephone | 262-877-4884
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Fax | 262-877-4629
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Provider Business Mailing Address
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Address Line | 3915 30TH AVE
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City | KENOSHA
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State | WI
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Zip | 53144-1957
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Country | US
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Telephone | 262-657-0222
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Fax | 262-657-7190
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 070.013399
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License Number State | IL
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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 | 9729-024
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License Number State | WI
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