Individual
LISA JULIANN CARLSON WEBER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
425 PINE RIDGE BLVD, SUITE 209, WAUSAU, WI 54401-4123
(715) 847-0400
Mailing address
PO BOX 8004, WAUSAU, WI 54402-8004
(715) 847-2304
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2463
WI
Other
Enumeration date
06/30/2009
Last updated
10/13/2014
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