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Individual

LARA MICHELLE PATTERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LAC

Contact information

Practice address
4010 PLEASANT LN, MOUNT PLEASANT, WI 53405-4839
(608) 358-2830
Mailing address
4010 PLEASANT LN, MOUNT PLEASANT, WI 53405-4839
(608) 358-2830

Taxonomy

Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
997-55
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
997-55
DEPT OF SAFETY AND PROFESSIONAL SERVICES
WI
Enumeration date
05/19/2020
Last updated
06/18/2020
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