Provider Demographics
NPI:1801761408
Name:BIENHOLD, LILA JO
Entity type:Individual
Prefix:
First Name:LILA
Middle Name:JO
Last Name:BIENHOLD
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 W DOTY ST UNIT 102
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53703-4738
Mailing Address - Country:US
Mailing Address - Phone:608-698-0227
Mailing Address - Fax:
Practice Address - Street 1:530 W DOTY ST UNIT 102
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53703-4738
Practice Address - Country:US
Practice Address - Phone:608-698-0227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-06
Last Update Date:2025-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer