Individual
DR. LISA D. CONRAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
765 LIBERTY ST, SUITE 111, MEADVILLE, PA 16335-2566
(814) 336-6384
(814) 336-1372
Mailing address
765 LIBERTY ST, SUITE 111, MEADVILLE, PA 16335-2566
(814) 336-6384
(814) 336-1372
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
OS010956L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001918170
—
PA
Enumeration date
06/29/2006
Last updated
07/09/2007
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