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Organization
LISA A. CORNELIUS DPM PC
Active
Organization
LISA A. CORNELIUS DPM PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LISA ANN CORNELIUS DPM (PHYSICIAN)
(541) 757-7100
Entity
Organization
Contact information
Practice address
3640 NW SAMARITAN DR, CORVALLIS, OR 97330-3784
(541) 757-7100
(541) 757-7101
Mailing address
3640 NW SAMARITAN DR, CORVALLIS, OR 97330-3784
(541) 757-7100
(541) 757-7101
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
DP00209
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
021324
—
OR
Enumeration date
03/20/2008
Last updated
04/17/2008
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