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Individual

DR. LISA A HART

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DC LAC

Contact information

Practice address
307 6TH ST, CARROLLTON, IL 62016
(217) 942-9069
(217) 942-6769
Mailing address
307 6TH ST, CARROLLTON, IL 62016
(217) 942-9069
(217) 942-6769

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038007515
IL
171100000X
Acupuncturist
198000091
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
03105605
BCBS BLUE CROSS BLUE SHIE
IL
Enumeration date
08/24/2006
Last updated
03/15/2012
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