Most Relevant Information
Provider Data
| NPI Number: | 1003474065 |
| Provider Name: | ALEXANDER JERROLD EGGEN DPT |
| Entity Type: | Individual |
| Taxonomy Code: | 225100000X |
| Specialty: | Physical Therapist |
| License Number: | 14606-24 |
Most Important Dates
| Enumeration Date: | 06/04/2019 |
| Last Updated: | 06/04/2019 |
Provider Practice Location
113 4TH AVE
SHELL LAKE
WI
548714457
Practice Location Phone/Fax
| Phone: | 7154687833 |
| Fax: |
Provider Mailing Location
113 4TH AVE
SHELL LAKE
WI
548714457
Provider Mailing Phone/Fax
| Phone: | 7154687833 |
| Fax: |