Individual
MS. LISA ANN WALTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
1822 NOTTINGHAM DR, INDIANAPOLIS, IN 46240-1240
(317) 258-2610
(317) 569-9796
Mailing address
1822 NOTTINGHAM DR, INDIANAPOLIS, IN 46240-1240
(317) 258-2610
(317) 569-9796
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05001595A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200710230 A
PROVIDER NUMBER
IN
Enumeration date
04/06/2007
Last updated
07/08/2007
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