Provider Demographics
NPI:1205847670
Name:JACOBSON, DAWN CYNTHIA (MA, ATC, NASM-CES)
Entity Type:Individual
Prefix:MS
First Name:DAWN
Middle Name:CYNTHIA
Last Name:JACOBSON
Suffix:
Gender:F
Credentials:MA, ATC, NASM-CES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 W ADAMS ST
Mailing Address - Street 2:
Mailing Address - City:BLACK RIVER FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:54615-9108
Mailing Address - Country:US
Mailing Address - Phone:715-284-1338
Mailing Address - Fax:
Practice Address - Street 1:711 W ADAMS ST
Practice Address - Street 2:
Practice Address - City:BLACK RIVER FALLS
Practice Address - State:WI
Practice Address - Zip Code:54615-9108
Practice Address - Country:US
Practice Address - Phone:715-284-1338
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2014-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer