Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 11466-24 | WI |
NPI | 1003184003 |
---|---|
Provider Name | Lindsay B.n. Laubmeier |
First Address | Sherman Oaks, CA 91423-5597 |
Second Address | Kenosha, WI 53144-1695 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/12/2011 |
Last Update Date | 11/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
859400070 | MEDICARE (01) | WI |