| NPI | 1295920205 |
|---|---|
| Former Name | LISA M MAZURENKO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist Orthopedic (Licence: MA 6661) |
| Additional Taxonomies | 2251X0800X Physical Therapist Orthopedic (Licence: NH 12221) |
| Enumeration Date | 2007-09-12 |
| Last Update Date | 2007-09-12 |