Provider Demographics
NPI:1326505579
Name:KRIZAN, JORDAN MARIE (PT, DPT, AT, ATC)
Entity type:Individual
Prefix:
First Name:JORDAN
Middle Name:MARIE
Last Name:KRIZAN
Suffix:
Gender:F
Credentials:PT, DPT, AT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:512 W 8TH ST
Mailing Address - Street 2:
Mailing Address - City:MARSHFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:54449-3607
Mailing Address - Country:US
Mailing Address - Phone:608-396-1013
Mailing Address - Fax:
Practice Address - Street 1:204 N CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:MARSHFIELD
Practice Address - State:WI
Practice Address - Zip Code:54449-2148
Practice Address - Country:US
Practice Address - Phone:715-898-1600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-25
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer