Individual
LORI ANN KEISIC HUMMEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1160 KEPLER DR, GREEN BAY, WI 54311
(920) 288-5475
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
9908
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100023056
—
WI
Enumeration date
04/23/2012
Last updated
04/04/2025
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