Individual
LISA MARA MEEHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
721 RESERVOIR AVE, CRANSTON, RI 02910-4430
(401) 946-4250
(401) 275-5645
Mailing address
721 RESERVOIR AVE, CRANSTON, RI 02910-4430
(401) 946-4250
(401) 275-5645
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT02001
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31206
BLUE CROSS
RI
01
—
413108
BLUECHIP OF RI
RI
Enumeration date
06/30/2006
Last updated
09/30/2008
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