Individual
LISA THEIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
407 N 8TH ST, MT. HOREB, WI 53572
(608) 437-5511
Mailing address
160 HOSPITAL DR, RATON, NM 87740-2002
(575) 445-0111
Taxonomy
Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
2995
NM
Other
Enumeration date
05/13/2008
Last updated
10/05/2015
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