Individual
LORI JEAN SIMON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
3640 WHITROCK AVE, WISCONSIN RAPIDS, WI 54494-7791
(715) 630-8000
Mailing address
3640 WHITROCK AVE, WISCONSIN RAPIDS, WI 54494-7791
(715) 630-8000
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
316312-31
WI
Other
Enumeration date
11/22/2013
Last updated
11/25/2013
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