Individual
LISA E BIRCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1190 E PARADISE DR, WEST BEND, WI 53095-5444
(262) 306-6319
Mailing address
1700 W PARADISE DR, WEST BEND, WI 53095-9795
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
562
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40762500
—
WI
Enumeration date
10/24/2006
Last updated
07/08/2007
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