Individual
MRS. LISA ANN REVELIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
1739 N 6TH ST, SHEBOYGAN, WI 53081-2706
(920) 208-1613
Mailing address
1739 N 6TH ST, SHEBOYGAN, WI 53081-2706
(920) 208-1613
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4390-24
WI
Other
Enumeration date
06/14/2016
Last updated
06/14/2016
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