Lisa Lynn Widder, PTA, LMT is a
Physical Therapy Assistant based in Madison, Wisconsin. Lisa Lynn Widder is licensed to practice in Wisconsin (license number 2260) and her current practice location is
5249 E Terrace Dr, Madison, Wisconsin. She can be reached at her office (for appointments etc.) via phone at
(608) 222-9777.
NPI number for Lisa Lynn Widder is 1912614686 and her current mailing address is 301 E Main St Apt 312, Waunakee, Wisconsin. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1912614686.
Healthcare Provider's Profile
Full Name | Lisa Lynn Widder |
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Gender | Female |
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Speciality | Physical Therapy Assistant |
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Location | 5249 E Terrace Dr, Madison, Wisconsin |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1912614686
- Provider Enumeration Date: 11/02/2022
- Last Update Date: 11/02/2022
Medical Identifiers
Medical identifiers for Lisa Lynn Widder such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1912614686 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
225700000X | Massage Therapist | 15749 (Wisconsin) | Secondary |
225200000X | Physical Therapy Assistant | 2260 (Wisconsin) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Lisa Lynn Widder is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Lisa Lynn Widder, PTA, LMT 301 E Main St Apt 312, Waunakee, WI 53597-1481 Ph: (815) 608-1577 | Lisa Lynn Widder, PTA, LMT 5249 E Terrace Dr, Madison, WI 53718-8339 Ph: (608) 222-9777 |
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