Individual
LAURIE ANN BACKHAUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
N27W5707 LINCOLN BLVD, CEDARBURG, WI 53012-2852
(262) 376-7676
Mailing address
N27W5707 LINCOLN BLVD, CEDARBURG, WI 53012-2852
(126) 237-6767
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1130-019
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40457200
—
WI
Enumeration date
05/11/2007
Last updated
07/08/2007
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