LISA D RADERSTORF

SOUTH BEND, IN
NPI1245421031
Former NameLISA DAWN NOLLENBERGER
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: IN  10000915A)
Enumeration Date2007-08-06
Last Update Date2011-12-02
Business Address
Mrs. LISA D RADERSTORF PA-C
5838 W BRICK RD SUITE 106
SOUTH BEND, IN 46628-8423
Phone number: 574-247-1911
Mailing Address
Mrs. LISA D RADERSTORF PA-C
PO BOX 1239
TROY, MI 48099-1239
Phone number: 248-824-6600