Individual
LISA MARIE LEANNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
HIS
Contact information
Practice address
1566 W MASON ST, GREEN BAY, WI 54303-2274
(920) 497-7944
(920) 497-7877
Mailing address
1566 W MASON ST, GREEN BAY, WI 54303-2274
(920) 497-7944
(920) 497-7877
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
1275-060
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42840000
—
WI
Enumeration date
03/05/2008
Last updated
03/05/2008
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