Individual
MRS. LISA MARY KOKONTIS
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
130 2ND STREET, WEST PAVILION 2ND FLOOR THE NEUROSCIENCE GROUP OF NE WI, NEENAH, WI 54956-2883
(920) 725-9373
(920) 720-7392
Mailing address
130 2ND STREET, WEST PAVILION 2ND FLOOR THE NEUROSCIENCE GROUP OF NE WI, NEENAH, WI 54956-2883
(920) 725-9373
(920) 720-7392
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
40464
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32494700
—
WI
Enumeration date
05/11/2006
Last updated
07/08/2007
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