| Doctor Name: | LISA CENTILLI |
| NPI Number: | 1033417522 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | D.O. |
| License Number: | 51010119542 |
| Business Practice Address: | 15855 19 Mile Rd Clinton Township, MI - 480383504 |
| Business Phone Number: | 5862633400 |
| Business Fax Number: | |
| Mailing Address: | 15400 19 Mile Road, CLINTON TOWNSHIP |
| State: | MI |
| Postal Code: | 483483504 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 03/07/2011 |
| NPI Last Update Date: | 06/23/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207QA0505X |
| License Number: | 51010119542 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Family Medicine |
| Taxonomy Specialization: | Adult Medicine |
| Taxonomy Definition: | |