Individual
LISA GRILL DODSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2720 PLAZA DR, SUITE 1100, WAUSAU, WI 54401-4158
(715) 847-2472
Mailing address
2720 PLAZA DR, SUITE 1100, WAUSAU, WI 54401-4158
(715) 847-2472
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
63624
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
024096
—
OR
Enumeration date
08/02/2006
Last updated
12/01/2021
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