Individual
LISA LACOURSIERE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1142 ORLANDO DR, DE PERE, WI 54115-9484
(920) 339-0700
(920) 330-0278
Mailing address
N1354 TUCKAWAY CT, GREENVILLE, WI 54942-8045
(920) 757-9485
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3933024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40253100
—
WI
Enumeration date
08/23/2007
Last updated
08/23/2007
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