Individual
LISA M ALLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
5500 KNOLL NORTH DR, COLUMBIA, MD 21045-2370
(443) 542-0062
Mailing address
250 CHARITA WAY, SEVERNA PARK, MD 21146-4004
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
A0000687
MD
Other
Enumeration date
06/27/2016
Last updated
06/27/2016
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