# MRS. LISA ANN MCGOWAN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1912102443
- **Gender:** F
- **Credential:** PT

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 005190 | CT | Yes |

## Other

- **Enumeration date:** 06/15/2007
- **Last updated:** 03/17/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0014101 | ORTHONET HEALTHNET | CT |
| 05 | — | 004189024 | — | CT |
| 01 | — | 061503332005 | TRICARE | CT |
| 01 | — | 14101 | ORTHONET CIGNA | CT |
| 01 | — | A2752221 | OXFORD | CT |