Basic Information
| Provider Information | |||||||||
| NPI: | 1699294660 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | RAMSBY | ||||||||
| FirstName: | JACOB | ||||||||
| MiddleName: | P | ||||||||
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| Credential: | PT, DPT, CSCS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 14815 ROWLEY RD | ||||||||
| Address2: | |||||||||
| City: | DURAND | ||||||||
| State: | IL | ||||||||
| PostalCode: | 610249695 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 900 BOYCE DR | ||||||||
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| City: | RHINELANDER | ||||||||
| State: | WI | ||||||||
| PostalCode: | 545013835 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7153656832 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/11/2017 | ||||||||
| LastUpdateDate: | 01/22/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 13965-24 | WI | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 225100000X | PT294475 | CA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.