Individual
LORI LAWRENCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1515 PARK AVE, COLUMBUS, WI 53925-1618
(920) 623-1430
Mailing address
1515 PARK AVE, COLUMBUS, WI 53925-1618
(920) 623-1430
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4437-24
WI
Other
Enumeration date
01/25/2016
Last updated
01/25/2016
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