| Doctor Name: | DR. LISA JAYNE WATTERS |
| NPI Number: | 1619962149 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | D.P.M. |
| License Number: | SC003169L |
| Business Practice Address: | 3275 Leechburg Rd Suite 2 Lower Burrell, PA - 150682858 |
| Business Phone Number: | 7243393500 |
| Business Fax Number: | 7243398331 |
| Mailing Address: | 3275 Leechburg Rd, Suite 2 LOWER BURRELL |
| State: | PA |
| Postal Code: | 150682858 |
| Phone Number: | 7243393500 |
| Fax Number: | 7243398331 |
| NPI Enumeration Date: | 09/12/2005 |
| NPI Last Update Date: | 10/16/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213EP1101X |
| License Number: | SC003169L |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | PA |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Primary Podiatric Medicine |
| Taxonomy Definition: | |