Individual
LISA INGRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
727 STONE AVE, TALLADEGA, AL 35160-2218
(256) 362-9477
(256) 362-9255
Mailing address
1837 PLEASANT RIDGE DR, SYLACAUGA, AL 35150-1761
(256) 249-3594
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
397
AL
Other
Enumeration date
09/16/2006
Last updated
07/08/2007
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