Individual
LISA JENKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LOTA
Contact information
Practice address
4510 27TH ST, LUBBOCK, TX 79410-1709
(806) 785-2464
(806) 785-2464
Mailing address
4410 17TH ST, LUBBOCK, TX 79416-5702
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
208992
TX
Other
Enumeration date
05/02/2007
Last updated
07/08/2007
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