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Individual
MRS. LISA SUZANNE MCCOLGAN
Active
Individual
MRS. LISA SUZANNE MCCOLGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT5838
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11173401
CITRUS HLC
FL
01
—
354737
WELLCARE
FL
01
—
Y020K
BCBS
FL
Enumeration date
01/11/2007
Last updated
07/08/2007
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