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NPI Code Detail

MEDICARE: JACOB SZYMANSKI OTR/L

MEDICARE:   JACOB  SZYMANSKI  OTR/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist7077-26WI

General Provider Information

NPI Number : 1215603204
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACOB SZYMANSKI OTR/L
Provider Business Mailing Address
First Line : 1100 COMMERCE DR STE 103
Second Line :
City : MT PLEASANT
State : WI
Zip : 53406-3700
Country : US
Telephone Number : 262-497-7270
Fax Number :
Provider Business Practice Location Address
First Line : 2335 S GREEN BAY RD
Second Line :
City : RACINE
State : WI
Zip : 53406-4923
Country : US
Telephone Number : 262-497-7270
Fax Number : 877-540-0135
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2021
Last Update Date : 02/22/2023

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Directions to “ JACOB SZYMANSKI OTR/L” Practice Location

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