Individual
MS. LISA K SHAW
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PMAC
Contact information
Practice address
6100 OLD JOHNSTOWN RD, HARRISBURG, PA 17112
(717) 541-0988
(717) 541-8838
Mailing address
PO BOX 526, 23 N MAIN ST, RIGLERVILLE, PA 17307
(717) 677-9288
(717) 677-4196
Taxonomy
Speciality
Code
Description
License number
State
211D00000X
Podiatric Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3398
APMAA
PA
Enumeration date
01/20/2006
Last updated
07/08/2007
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