Individual
LUCAS D GAUTHIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
1931 MARINETTE AVE, MARINETTE, WI 54143-3801
(715) 735-5500
(715) 735-5502
Mailing address
2105 E ENTERPRISE AVE STE 113, APPLETON, WI 54913-7862
(920) 560-1083
(920) 560-1098
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
14425-24
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14425-24
STATE LICENSE
WI
Enumeration date
08/27/2018
Last updated
07/11/2025
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