Individual
ELIZABETH MARIE THEIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
222 CHRISTINES WAY, RANDOM LAKE, WI 53075-1680
(920) 889-5056
Mailing address
222 CHRISTINES WAY, RANDOM LAKE, WI 53075-1680
Taxonomy
Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
—
—
Other
Enumeration date
07/22/2019
Last updated
07/22/2019
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