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Individual

SALLY NELSON LYSNE

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
OTR

Contact information

Practice address
310 W MAIN ST, SPARTA, WI 54656-2170
(608) 269-2132
(608) 269-8110
Mailing address
700 WEST AVE S, ATTN PHYSICIAN SERVICES, LA CROSSE, WI 54601-4783
(608) 791-4156
(608) 791-9898

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2826
WI

Other

Enumeration date
12/08/2005
Last updated
07/08/2007
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