Individual
LISA POLHAMUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6872 189TH ST, CHIPPEWA FALLS, WI 54729-6413
(715) 723-7602
Mailing address
6872 189TH ST, CHIPPEWA FALLS, WI 54729-6413
(715) 723-7602
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
126846
WI
Other
Enumeration date
11/08/2014
Last updated
11/08/2014
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