Individual
LISA MACEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
605 W JUANITA AVE, GILBERT, AZ 85233-2673
(603) 591-0445
Mailing address
605 W JUANITA AVE, GILBERT, AZ 85233-2673
(603) 591-0445
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
12401-24
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12401-24
STATE LICENSE
WI
Enumeration date
07/30/2013
Last updated
11/17/2023
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