Individual
LISA JAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10101 W WISCONSIN AVE, MILWAUKEE, WI 53226-4861
(262) 661-9100
Mailing address
845 GEORGES AVE, BROOKFIELD, WI 53045-6737
(262) 661-9100
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
4109-19
WI
Other
Enumeration date
08/31/2023
Last updated
08/31/2023
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