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Individual

DAVID LISAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
913 MONTGOMERY AVE, PENN VALLEY, PA 19072-1501
(610) 664-3400
(610) 664-8482
Mailing address
913 MONTGOMERY AVE, PENN VALLEY, PA 19072-1501
(610) 664-3400
(610) 664-8482

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
OS009840L
PA
208D00000X
General Practice Physician
OS7820
FL
225100000X
Physical Therapist
DAPT001519
PA
225100000X
Physical Therapist
PT007501L
PA
225100000X
Physical Therapist
PT21515
FL

Other

Enumeration date
11/08/2006
Last updated
12/12/2016
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