Provider Demographics
NPI:1427187053
Name:VOJTA, JENNIFER A (ATC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:A
Last Name:VOJTA
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1550
Mailing Address - Street 2:
Mailing Address - City:WOODRUFF
Mailing Address - State:WI
Mailing Address - Zip Code:54568-1550
Mailing Address - Country:US
Mailing Address - Phone:715-356-9999
Mailing Address - Fax:715-356-9894
Practice Address - Street 1:1446 HWY 47
Practice Address - Street 2:
Practice Address - City:WOODRUFF
Practice Address - State:WI
Practice Address - Zip Code:54568
Practice Address - Country:US
Practice Address - Phone:715-356-9999
Practice Address - Fax:715-356-9894
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2009-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI8762255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer