Individual
MS. LISA CUSHING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
7111 E 21ST ST N STE 103, WICHITA, KS 67206-1090
(316) 269-1311
(316) 269-1588
Mailing address
200 W DOUGLAS AVE STE 250, WICHITA, KS 67202-3002
(316) 263-0003
(316) 263-1241
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1102681
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200608760B
—
KS
Enumeration date
02/16/2007
Last updated
01/11/2023
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