| Doctor Name: | LISA J VIS |
| NPI Number: | 1083715619 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MSPT |
| License Number: | L742129 |
| Business Practice Address: | 5570 Wilson Ave Sw Suite A Grandville, MI - 494188867 |
| Business Phone Number: | 6165942000 |
| Business Fax Number: | 6165942004 |
| Mailing Address: | 2120 43rd St Se, Suite 100 GRAND RAPIDS |
| State: | MI |
| Postal Code: | 495083772 |
| Phone Number: | 6162811144 |
| Fax Number: | 6162811221 |
| NPI Enumeration Date: | 09/26/2006 |
| NPI Last Update Date: | 11/16/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | L742129 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MI |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |