Individual
LAURIE LEE WOLF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
510 N 17TH AVE, SUITE A1, WAUSAU, WI 54401-4200
(715) 298-5783
(715) 298-5784
Mailing address
510 N 17TH AVE, SUITE A1, WAUSAU, WI 54401-4200
(715) 298-5783
(715) 298-5784
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
30639
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31530200
—
WI
Enumeration date
08/09/2005
Last updated
11/21/2016
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