Individual
MS. LISA LYN SHOVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
63 SPRING ST, NEWPORT, VT 05855-5819
(802) 334-6242
Mailing address
63 SPRING ST, NEWPORT, VT 05855-5819
(802) 334-6242
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
08228
MA
314000000X
Skilled Nursing Facility
—
—
Other
Enumeration date
07/31/2008
Last updated
10/08/2014
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