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1811355290
LISA GOLLY
VALPARAISO, IN
NPI
1811355290
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: IN 06005162A)
Enumeration Date
2016-02-01
Last Update Date
2016-02-01
Business Address
-- LISA GOLLY PTA
503 LANCASTER DR
VALPARAISO, IN 46383-1928
Phone number: 219-508-7350
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Mailing Address
-- LISA GOLLY PTA
503 LANCASTER DR
VALPARAISO, IN 46383-1928
Phone number: 219-508-7350
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