Individual
MRS. MARY LAKOMY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
421 18TH AVENUE, UNION GROVE, WI 53182-1764
(262) 878-2873
Mailing address
421 18TH AVENUE, UNION GROVE, WI 53182-1764
(262) 878-2873
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
279-19
WI
Other
Enumeration date
05/01/2007
Last updated
10/12/2012
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