Individual
MS. LISA M MACKNAIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
630 PLANTATION ST FL ST12, WORCESTER, MA 01605-2038
(774) 261-1356
Mailing address
460 SOUTHBRIDGE ST, READYMED, AUBURN, MA 01501-2442
(774) 221-5135
(774) 221-5136
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA4505
MA
363AM0700X
Medical Physician Assistant
Primary
PA4505
MA
Other
Enumeration date
09/12/2012
Last updated
09/03/2025
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