Individual
LISA LANDIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
9390 THE LANDING DR # 201, DOUGLASVILLE, GA 30135-7180
(770) 852-1692
Mailing address
1152 LAFAYETTE DR SW, MABLETON, GA 30126-5537
(912) 293-7056
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA003940
GA
Other
Enumeration date
08/21/2025
Last updated
08/21/2025
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