Individual
LISA M VICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
600 HIGHLAND AVE, MADISON, WI 53792-0001
(608) 263-6400
Mailing address
6192 DRISCOLL DR, MADISON, WI 53718-3033
(619) 599-3255
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
7065-27
WI
Other
Enumeration date
06/11/2025
Last updated
06/11/2025
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