Individual
MS. LISA TILLMAN EDISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2331 CANAL ST, NEW ORLEANS, LA 70119-6503
(304) 307-3737
Mailing address
PO BOX 3017, HARVEY, LA 70059-3017
(504) 451-7337
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
04/26/2018
Last updated
04/27/2018
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