Individual
LISA OBRYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
108 S 3RD ST, FISHER, IL 61843-9549
(217) 897-1444
(217) 897-1448
Mailing address
PO BOX 324, FISHER, IL 61843-0324
(217) 897-1444
(217) 897-1448
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
227011821
IL
Other
Enumeration date
07/19/2014
Last updated
07/19/2014
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