Individual
KAIZIE R. LAAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
1818 N MEADE ST, APPLETON, WI 54911-3454
(920) 731-4101
Mailing address
1818 N MEADE ST, APPLETON, WI 54911-3454
(920) 731-4101
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10200
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40409100
—
WI
Enumeration date
06/26/2006
Last updated
08/23/2008
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