Provider Demographics
NPI:1770838633
Name:LORRIGAN, LISA A (DPT)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:A
Last Name:LORRIGAN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:A
Other - Last Name:LALLENSACK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5300 MEMORIAL DRIVE
Mailing Address - Street 2:
Mailing Address - City:TWO RIVERS
Mailing Address - State:WI
Mailing Address - Zip Code:54241
Mailing Address - Country:US
Mailing Address - Phone:920-793-7570
Mailing Address - Fax:920-793-7571
Practice Address - Street 1:5300 MEMORIAL DRIVE
Practice Address - Street 2:
Practice Address - City:TWO RIVERS
Practice Address - State:WI
Practice Address - Zip Code:54241
Practice Address - Country:US
Practice Address - Phone:920-793-7570
Practice Address - Fax:920-793-7571
Is Sole Proprietor?:No
Enumeration Date:2012-07-17
Last Update Date:2014-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI12063225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist