Lori Solberg Pothast, P.T.
Individual provider Active NPI Physical Therapist · Sister Bay, WI
NPI 1194850271 · NPPES record last updated Aug 9, 2024
Key facts
- NPI
- 1194850271
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 13511 (WI)
- Practice address
- 2345 Canterbury LN
Sister Bay, WI 54234-5602 - Phone
- (820) 854-4111
- NPI assigned
- Feb 22, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070004480 | IL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Michael Reilly M.D. Holistic & Family Practice Medicine LTD | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 070004480 | IL | |
| Physical Therapist | 225100000X | 13511 | WI | Yes |
Addresses
Primary practice location
2345 Canterbury LN
Sister Bay, WI 54234-5602
Mailing address
323 S 18TH Ave
Sturgeon Bay, WI 54235-1401
Phone (920) 743-5566
Other providers in Sister Bay, WI
- Northern Door Dental SC
- Northern Door Physical Therapy & Wellness LLC
- Anna Olson
- Elizabeth Ellen Patera-Butz
- Maynard Dillon Poland
- Joseph Joshua Rebhan
- Carol A Shabbit
- Shopko Stores Operating Co LLC
- Sister Bay Hometown Pharmacy LLC
- Sister Bay Pharmacy
All providers in Sister Bay, WI · Physical Therapist in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 9, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.