Organization
LISA A. CORNELIUS DPM PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LISA ANN CORNELIUS DPM (PHYSICIAN)
(541) 757-7100
Entity
Organization
Contact information
Practice address
3640 NW SAMARITAN DR, CORVALLIS, OR 97330-3784
(541) 757-7100
(541) 757-7101
Mailing address
3640 NW SAMARITAN DR, CORVALLIS, OR 97330-3784
(541) 757-7100
(541) 757-7101
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
DP00209
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
021324
—
OR
Enumeration date
03/20/2008
Last updated
04/17/2008
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