| NPI | 1306581129 |
|---|---|
| Former Name | LISA A FARNEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: VA 2306604026) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: 0019012791) |
| Enumeration Date | 2022-05-05 |
| Last Update Date | 2022-05-05 |