Individual provider · Type 1 NPI

Jacob Johnson

Physical Therapy Assistant · Oak Creek, WI

NPI number 1164310926 Active

Practice location

2700 W Honadel Blvd
Oak Creek, WI 53154-2650

Call (414) 420-2919 Map

Mailing address

2123 27th St
Kenosha, WI 53140-5011

Specialties and licenses

TaxonomyCodeLicense
Physical Therapy Assistant Primary 225200000X3213-19 (WI)

Physical Therapy Assistant: (1)Physical therapist assistants are skilled health care providers who are graduates of a physical therapist assistant associate degree program accredited by an agency recognized by the Secretary of the U.S. Department of Education or Council on Postsecondary Accreditation, who assists the physical therapist in providing physical therapy. The supervising physical therapist is directly responsible for the actions of …

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About NPI 1164310926

Jacob Johnson's National Provider Identifier is 1164310926, issued on Jun 27, 2025. The primary taxonomy on file is Physical Therapy Assistant (225200000X), and the practice location is in Oak Creek, WI. The record was last updated on Jun 27, 2025.