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Lydiawati Kurniawan, PTA
NPI 1487922316 · on the registry since 2011 · sole proprietor
Practice
- Address
- E7404a County Road Bb
Viroqua, WI 54665 - Phone
- (608) 637-5422
- Clinicians at this address
- 3
Registry record
- Primary taxonomy
- 225200000X
225200000X
- Licence states on file
- WI
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2011-12-07
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Wisconsin