Individual
MRS. LISA M MACHOTKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1767 PARK AVE, PLOVER, WI 54467-4301
(715) 344-1260
Mailing address
225000 HUMMINGBIRD RD STE 100, WAUSAU, WI 54401-2950
(715) 359-6442
(715) 393-0390
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5855-24
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40401400
—
WI
Enumeration date
11/30/2006
Last updated
06/07/2022
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