Individual
LISA R GAMBLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
19395 W CAPITOL DR, BROOKFIELD, WI 53045-2736
(262) 923-7101
Mailing address
2809 N 7TH ST, SHEBOYGAN, WI 53083-4246
(920) 917-5250
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
6170-26
WI
Other
Enumeration date
06/14/2021
Last updated
06/14/2021
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