Individual
DR. LISA M KWISNEK-LAMANTIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
25 COLONY BLVD STE 102, BLAIRSVILLE, PA 15717-7971
(724) 459-9111
(724) 459-7856
Mailing address
25 COLONY BLVD STE 102, BLAIRSVILLE, PA 15717-7971
(724) 459-9111
(724) 459-7856
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
OS015137
PA
208M00000X
Hospitalist Physician
Primary
OS015137
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1024757490002
—
PA
Enumeration date
06/09/2010
Last updated
11/14/2017
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