Individual
LISA A GREENWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
8806 COLDWATER RD, FORT WAYNE, IN 46825-2715
(260) 482-4327
(260) 482-4320
Mailing address
8806 COLDWATER RD, FORT WAYNE, IN 46825-2715
(260) 482-4327
(260) 482-4320
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
23002271A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200341310
—
IN
Enumeration date
12/20/2005
Last updated
08/23/2021
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