Individual
LAURIE DYBUL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
10602 N PORT WASHINGTON RD, SUITE 101, MEQUON, WI 53092-5079
(262) 241-8030
(262) 241-8304
Mailing address
249 SAINT ROSE AVE, FREDONIA, WI 53021-9479
(262) 483-3625
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
9880-024
WI
Other
Enumeration date
09/15/2006
Last updated
07/08/2007
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