Individual
DR. JOHN WALTER LACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
1303 MAIN STREET S, HOLMEN, WI 54636-8927
(608) 785-0940
Mailing address
P O BOX 860912, MINNEAPOLIS, MN 55486-0912
(507) 284-2511
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
110965
IA
103G00000X
Clinical Neuropsychologist
5000-57
WI
103T00000X
Psychologist
110965
IA
103T00000X
Psychologist
5000-57
WI
103TC0700X
Clinical Psychologist
Primary
5000-57
WI
103TH0100X
Health Service Psychologist
126559
IA
Other
Enumeration date
05/17/2022
Last updated
12/23/2025
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