Provider Demographics
NPI:1972632842
Name:LOIS, WILLIAM (DPT)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:
Last Name:LOIS
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2121 S KINNICKINNIC AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53207-1364
Mailing Address - Country:US
Mailing Address - Phone:414-744-0707
Mailing Address - Fax:414-744-0708
Practice Address - Street 1:2121 S KINNICKINNIC AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53207-1364
Practice Address - Country:US
Practice Address - Phone:414-744-0707
Practice Address - Fax:414-744-0708
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2022-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI10406-24225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI36143300Medicaid