Doctor Name: | MRS. LISA MICHELLE LUER |
NPI Number: | 1346348786 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | P.T. |
License Number: | 01873 |
Business Practice Address: | 1 Rose Ct Glen Carbon, IL - 620341392 |
Business Phone Number: | 6183401014 |
Business Fax Number: | 6182886416 |
Mailing Address: | 1 Rose Ct, GLEN CARBON |
State: | IL |
Postal Code: | 620341392 |
Phone Number: | 6183401014 |
Fax Number: | 6182886416 |
NPI Enumeration Date: | 09/20/2006 |
NPI Last Update Date: | 09/18/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2251P0200X |
License Number: | 01873 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MO |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | Pediatrics |
Taxonomy Definition: |