Individual
LAURIE G PRESTBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
1190 E PARADISE DR, WEST BEND, WI 53095-5444
(262) 306-6319
(262) 306-2964
Mailing address
1700 W PARADISE DRIVE, WEST BEND, WI 53095-9795
(262) 334-3451
(262) 306-2964
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2142
WI
225100000X
Physical Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1700015518
—
WI
01
—
2142-024
STATE LICENSE
WI
Enumeration date
07/14/2009
Last updated
09/23/2009
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