Individual
LYNN WINTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3821 S CHICAGO AVE, SOUTH MILWAUKEE, WI 53172-3712
(414) 762-6379
Mailing address
9068 S RIVER EDGE DR, OAK CREEK, WI 53154-3734
(414) 762-6379
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
616019
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40094000
—
WI
01
—
616 019
LIC #
WI
Enumeration date
05/02/2007
Last updated
07/09/2007
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