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Individual

MRS. LISA KAY SUMMERLOT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
1100 SOUTHFIELD DR, PLAINFIELD, IN 46168-4498
(317) 838-3434
Mailing address
242 OXMOOR WAY APT G, AVON, IN 46123-1165
(317) 273-0810

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11370-024
WI
2251X0800X
Orthopedic Physical Therapist
05007342A
IN

Other

Enumeration date
12/24/2009
Last updated
06/28/2010
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