Individual
MS. LISA MARIE BETTIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.R.P.T.
Contact information
Practice address
8872 FORD AVE STE 206, RICHMOND HILL, GA 31324-6092
(912) 312-2766
Mailing address
8872 FORD AVE STE 206, RICHMOND HILL, GA 31324-6092
(912) 312-2766
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
007195
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
650025450
RR MEDICARE
GA
01
—
853202
BCBS
GA
Enumeration date
07/15/2005
Last updated
09/20/2022
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