Individual
LISA SCHAEFER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
272 SCHOOL AVE, WEST FORK, AR 72774-3124
(479) 839-3349
(479) 839-3752
Mailing address
PO DRAWER 2109, RUSSELLVILLE, AR 72811
(479) 967-2322
(479) 967-2876
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
2749
AR
225100000X
Physical Therapist
Primary
PT2749
AR
225100000X
Physical Therapist
PT5394
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
154417721
—
AR
01
—
445934001
PALMETTO GI DME
AR
01
—
5X979
BLUE CROSS BLUE SHIELD
AR
01
—
662725
HEALTHLINK
AR
01
—
71085780150
QUALCHOICE
AR
Enumeration date
05/04/2006
Last updated
01/16/2023
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