Individual
MRS. LISA T. HOGLUND
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PT, OCS
Contact information
Practice address
7901 BUSTLETON AVE, SUITE 204, PHILADELPHIA, PA 19152-3328
(215) 335-7400
(215) 335-7404
Mailing address
195 RICE DR, MORRISVILLE, PA 19067-5961
(215) 428-0244
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
PT002542E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0824186000
BC/BS HMO PROVIDER NUMBER
PA
01
—
7316644
AETNA
PA
01
—
800468
BC/BS PPO PROVIDER NUMBER
PA
Enumeration date
07/12/2005
Last updated
07/08/2007
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