Individual
MS. LISA MARIE FOUSEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1000 E WASHINGTON ST, MEDINA, OH 44256-2170
(330) 725-1000
Mailing address
2264 COVINGTON LN, MEDINA, OH 44256-6387
(330) 239-0612
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
005917
OH
Other
Enumeration date
02/06/2007
Last updated
07/08/2007
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