Individual
LISA KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
115 E ARNDT ST, FOND DU LAC, WI 54935-2461
(920) 923-7040
Mailing address
N104W15909 DONGES BAY RD, GERMANTOWN, WI 53022-4824
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
6724
WI
Other
Enumeration date
10/12/2020
Last updated
06/04/2021
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