Individual
LISA MARIE KOEHLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
426 MCMILLEN ST, FORT ATKINSON, WI 53538-1996
(920) 563-9357
Mailing address
112 MILWAUKEE AVE E, FORT ATKINSON, WI 53538-2049
(920) 563-7142
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1480-027
WI
Other
Enumeration date
05/04/2007
Last updated
07/08/2007
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