Individual
LISA GAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.P.T.
Contact information
Practice address
216 JOHNSTON ST SE, DECATUR, AL 35601-2516
(256) 686-2212
Mailing address
216 JOHNSTON ST SE, DECATUR, AL 35601-2516
(256) 686-2212
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PTH 1772
AL
Other
Enumeration date
05/20/2014
Last updated
05/20/2014
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