Individual
MS. MARY LISA FAUBLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
202 S PARK ST, MADISON, WI 53715-1507
(608) 417-6000
Mailing address
202 S PARK ST, MADISON, WI 53715-1507
(608) 417-6000
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
07/27/2017
Last updated
07/21/2022
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