Individual
MRS. LISA LEANNE GENTZLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.P.T.
Contact information
Practice address
1319 E KING AVE, KINGSLAND, GA 31548-6831
(404) 351-5307
(404) 351-5308
Mailing address
5307 YELLOWSTONE RD, CHEYENNE, WY 82009-4736
(307) 632-7677
(307) 778-8292
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT 1072
WY
225100000X
Physical Therapist
Primary
PT016970
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
313800
BLUE CROSS/BLUE SHIELD
WY
Enumeration date
10/23/2006
Last updated
09/11/2025
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