| NPI | 1265536650 |
|---|---|
| Former Name | LISA L FOWLER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO 9259) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: CO 9259) |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2022-07-21 |