| NPI | 1194069237 |
|---|---|
| Former Name | LISA JORDAN LEE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 24299) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: DE J1-0002908) |
| Enumeration Date | 2012-11-15 |
| Last Update Date | 2017-03-07 |