Individual
LISA NICHOLE CREADLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3053 BLITZ CT, VIRGINIA BEACH, VA 23453-3210
(757) 567-5360
Mailing address
3053 BLITZ CT, VIRGINIA BEACH, VA 23453-3210
(757) 567-5360
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306604310
VA
Other
Enumeration date
11/26/2025
Last updated
11/26/2025
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