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Individual
LISA MARIE ROPER
Active
Individual
LISA MARIE ROPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
B.S, ATC, LAT
Taxonomy
Speciality
Code
Description
License number
State
225500000X
Respiratory/Developmental/Rehabilitative Specialist/Technologist
Primary
AT-374
ID
2255A2300X
Athletic Trainer
AT-AT-148663
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1063455608
AT-374
OR
Enumeration date
06/13/2006
Last updated
12/03/2016
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