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1205975232
LISA MARIE FORESTAL
BUFFALO, NY
NPI
1205975232
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Former Name
LISA MARIE WELLER
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: NY 011316)
Enumeration Date
2007-02-06
Last Update Date
2009-11-25
Business Address
-- LISA MARIE FORESTAL PA
100 HIGH ST
BUFFALO, NY 14203-1126
Phone number: 716-859-1254
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Mailing Address
-- LISA MARIE FORESTAL PA
3435 MAIN ST HAYES A
BUFFALO, NY 14214-3001
Phone number: 716-829-3670
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