Individual
MRS. LISA KAY WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
556 AUBUCHON RD, TROY, MO 63379-4338
(636) 338-4095
Mailing address
556 AUBUCHON RD, TROY, MO 63379-4338
(636) 338-4095
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2000154583
MO
Other
Enumeration date
08/08/2007
Last updated
08/08/2007
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