Provider Demographics
NPI:1700089760
Name:LEMKE, JULIE LISABETH (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:LISABETH
Last Name:LEMKE
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
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Mailing Address - Street 1:S32 W25019 GREEN VALLEY DRIVE
Mailing Address - Street 2:
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53189
Mailing Address - Country:US
Mailing Address - Phone:262-521-9794
Mailing Address - Fax:
Practice Address - Street 1:19525 W NORTH AVE
Practice Address - Street 2:FRANCISCAN WOODS
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53045
Practice Address - Country:US
Practice Address - Phone:262-785-1114
Practice Address - Fax:262-780-3805
Is Sole Proprietor?:No
Enumeration Date:2007-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
5411024225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI40270500Medicaid