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Individual

KERRY L. LAHTI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MPT

Contact information

Practice address
9675 E ELM RD, POPLAR, WI 54864-9102
(715) 364-8565
(715) 364-8574
Mailing address
4000 N PROVIDENCE AVE, APPLETON, WI 54913-8018
(920) 257-2005
(920) 257-2004

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
9809-024
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
111196
SECURITY HEALTH PLAN
WV
01
382K3LA
GROUP HEALTH/BCBS OF MN
WI
05
40455700
WI
01
64-05466
MEDICA-POPLAR
WI
01
64-05467
MEDICA-ASHLAND
WI
01
P00210715
RAILROAD MEDICARE
WI
Enumeration date
08/07/2006
Last updated
06/26/2013
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