| Doctor Name: | LISA M NIETHAMER |
| NPI Number: | 1306101720 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PT |
| License Number: | PT-022126 |
| Business Practice Address: | 32 W Shortcut Rd Newport, PA - 170748721 |
| Business Phone Number: | 7175679954 |
| Business Fax Number: | 7175679975 |
| Mailing Address: | 215 Evergreen Dr, MARYSVILLE |
| State: | PA |
| Postal Code: | 170539786 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 07/11/2012 |
| NPI Last Update Date: | 04/01/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PT-022126 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| 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 |