Individual
LORI BERKOVITZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2409 WOODINGTON WAY, SUAMICO, WI 54173-7904
(920) 434-3124
Mailing address
2409 WOODINGTON WAY, SUAMICO, WI 54173-7904
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
115-019
WI
Other
Enumeration date
04/18/2008
Last updated
04/18/2008
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