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1235507039
MAXINE LIS
MEDFORD, NJ
NPI
1235507039
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Former Name
MAXINE MITJANS
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: NJ 40QA01619100)
Enumeration Date
2015-09-10
Last Update Date
2017-02-28
Business Address
-- MAXINE LIS PT, DPT
176 ROUTE 70 SUITE 37
MEDFORD, NJ 08055-8704
Phone number: 609-714-7733
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Mailing Address
-- MAXINE LIS PT, DPT
1377 MOTOR PKWY STE 307
ISLANDIA, NY 11749-5249
Phone number: 631-580-5200
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