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Individual

MRS. LISA TAMARA HARLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
95 LEONARD AVE, BUILDING 1, SUITE 202, WASHINGTON, PA 15301-3368
(724) 206-0610
(724) 503-4156
Mailing address
60 COMMERCE PLAZA CIR, PEMBROKE, NC 28372-7386
(910) 521-2900
(910) 775-9165

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
9904821A.
IN
363A00000X
Physician Assistant
Primary
363AM0700X
Medical Physician Assistant
0010-01739
NC

Other

Enumeration date
02/18/2009
Last updated
01/24/2017
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