Individual
LYNNE M LUKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1510 FREMONT ST, ALGOMA, WI 54201-1948
(920) 487-9888
Mailing address
323 S 18TH AVE, STURGEON BAY, WI 54235-1401
(920) 743-5566
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
503-19
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40324000
—
WI
Enumeration date
08/25/2006
Last updated
10/20/2016
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