Individual
LISA M. SIMONDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1120 MAIN ST, UNION GROVE, WI 53182-1328
(261) 878-4424
Mailing address
1120 MAIN ST, UNION GROVE, WI 53182-1328
(261) 878-4424
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
29896-020
WI
Other
Enumeration date
07/26/2006
Last updated
07/08/2007
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