| NPI | 1457444770 |
|---|---|
| Former Name | LISA M KNOWLTON |
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CT 7312) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CT 007312) |
| Enumeration Date | 2006-09-30 |
| Last Update Date | 2022-11-29 |