Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jacob Johnson

Individual provider Physical Therapy Assistant · NPI 1164310926

Jacob Johnson is a Physical Therapy Assistant in Oak Creek, Wisconsin. Practices as a sole proprietor. Licensed in Wisconsin.

Licensed in
WI
In the registry since
2025

Practice location Address checks out

2700 W Honadel Blvd
Oak Creek, WI 53154-2650
Phone: (414) 420-2919
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence 3213-19 (WI)

Record details

NPI number1164310926
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJune 27, 2025
Last updated in NPPESJune 27, 2025
Certification dateJune 27, 2025

Other providers in Oak Creek