Johnson, Lisa L

Johnson, Lisa L is an individual health care provider with primary practice located at 1190 E Paradise Dr , West Bend WI 53095-5444. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant, which is considered as her primary health care specialty. Johnson, Lisa L can be contacted via phone (262) 306-6319.

Contact Information

Primary practice address
1190 E Paradise Dr West Bend WI 53095-5444
Phone: (262) 306-6319
Fax: (262) 306-2964
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant 225200000X 378 Wisconsin

Profile Details

NPI number 1245552298
LBN Legal business name Johnson, Lisa L
Credentials Physical Therapist Assistant (PTA)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 18th, 2010
Last updated Feb 19th, 2010 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1245552298 NPPES
Wisconsin Other 378-19 STATE LICENSE

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