Individual
LEAH LISOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3896 MAYFIELD RD, JACKSON, WI 53037-9762
(262) 627-0751
Mailing address
3896 MAYFIELD RD, JACKSON, WI 53037-9762
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
363AS0400X
Surgical Physician Assistant
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/01/2025
Last updated
04/01/2025
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