Individual
LOIS L FLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
331 S WATER ST, SPARTA, WI 54656-1726
(608) 366-6239
Mailing address
331 S WATER ST, SPARTA, WI 54656-1726
(608) 366-6239
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
798-19
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
225200000X
PRIVATE INSURANCE
WI
Enumeration date
01/03/2012
Last updated
02/06/2015
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