Individual
LORI ANN DISSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA, CWT
Contact information
Practice address
10 TRI PARK WAY, APPLETON, WI 54914-1658
(920) 831-7902
(920) 831-7939
Mailing address
212 LILAC LN, LITTLE CHUTE, WI 54140-1118
(920) 687-1857
(920) 831-7939
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
790-019
WI
Other
Enumeration date
08/16/2006
Last updated
07/08/2007
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