Individual
KELSEY R LAUTERBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3113 SAEMANN AVE, SHEBOYGAN, WI 53081-1957
(920) 496-4700
Mailing address
N3094 BATES RD, CASCADE, WI 53011-1314
(715) 966-5609
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4851-23
WI
Other
Enumeration date
08/14/2018
Last updated
12/15/2021
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