Individual
DR. LISA HELMS SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
3302 LANTERN COACH LN NE, ROSWELL, GA 30075-3195
(404) 210-2093
Mailing address
3302 LANTERN COACH LN NE, ROSWELL, GA 30075-3195
(404) 210-2093
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT006128
GA
2251P0200X
Pediatric Physical Therapist
PT006128
GA
261QP2000X
Physical Therapy Clinic/Center
PT006128
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
550480402A
—
GA
Enumeration date
06/26/2007
Last updated
03/27/2020
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