Individual
MS. LISA ANNE ERWIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
1306 N EL PASO AVE, RUSSELLVILLE, AR 72801-8814
(479) 968-0642
Mailing address
820 SANDSTONE CIR, 11, RUSSELLVILLE, AR 72802-7101
(479) 264-3937
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT309
AR
Other
Enumeration date
01/03/2007
Last updated
07/08/2007
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