Individual
MRS. LISA JO TRICKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2125 ELIZABETH AVE, LAURELDALE, PA 19605-2259
(610) 927-9985
Mailing address
2125 ELIZABETH AVE, LAURELDALE, PA 19605-2259
(610) 927-9985
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
TE005976L
PA
Other
Enumeration date
10/08/2008
Last updated
10/08/2008
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