Individual
LISA M NULL
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1010 LIGONIER ST, LATROBE, PA 15650-1882
(724) 539-8581
(724) 539-1575
Mailing address
1010 LIGONIER ST, LATROBE, PA 15650-1882
(724) 539-8581
(724) 539-1575
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA051318
PA
Other
Enumeration date
03/01/2006
Last updated
07/08/2007
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