Individual
LISA DEMIDOWICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
2286 CROSSWIND DR STE C, PRESCOTT, AZ 86301-6100
(928) 225-2540
Mailing address
PO BOX 27077, PRESCOTT VALLEY, AZ 86312-7077
(928) 225-2540
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
0844
AZ
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
07/10/2014
Last updated
09/05/2019
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