Individual
MISTI C LIPSCOMB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1007 GOODYEAR AVE, GADSDEN, AL 35903-1195
(256) 494-4102
Mailing address
14050 NW 14TH ST, SUITE 190, SUNRISE, FL 33323-2865
(800) 424-3672
(954) 377-3042
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA-505
AL
Other
Enumeration date
06/13/2007
Last updated
07/08/2007
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