Lacoursiere, Lisa
Lacoursiere, Lisa is an individual health care provider with primary practice located at 1142 Orlando Dr , De Pere WI 54115-9484. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Lacoursiere, Lisa can be contacted via phone (920) 339-0700.Contact Information
Primary practice address
1142 Orlando Dr
De Pere WI 54115-9484
Phone: (920) 339-0700
Fax: (920) 330-0278
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | 3933024 | Wisconsin |
Profile Details
| NPI number | 1639362585 |
|---|---|
| LBN Legal business name | Lacoursiere, Lisa |
| Credentials | Physical Therapist (PT) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 23rd, 2007 |
| Last updated | Aug 23rd, 2007 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1639362585 | NPPES |
| Wisconsin | MEDICAID | 40253100 |
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