Individual
MR. MICHAEL JOHN LAVIOLETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T., D.P.T.
Contact information
Practice address
740 AEROSTAR LN, GREEN BAY, WI 54313-6987
(920) 661-9237
Mailing address
740 AEROSTAR LN, GREEN BAY, WI 54313-6987
(920) 661-9237
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6139-024
WI
Other
Enumeration date
01/28/2011
Last updated
01/28/2011
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