NPI 1174781983

Lisa M Back

Practitioner Physical Therapy Assistant Crystal River, FL

Practice location

Address: 394 N Suncoast Blvd Suite 40, Crystal River, FL 34429-5466
Phone: (352) 795-6225
Fax: (352) 795-6065

Registered specialties

Physical Therapy Assistant Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225200000X Licence PTA18639 (FL)

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Registry record

NPI: 1174781983
Entity type: Individual
Sex (as registered): Female
NPI issued: 29 May 2008
Record last updated: 29 May 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.