MEDICARE: MRS. LISA ANNE HAND T-DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	QA04222	NJ

General Provider Information

NPI Number	:	1942260625
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LISA ANNE HAND T-DPT

Provider Business Mailing Address
First Line	:	518 N GARFIELD AVE
Second Line	:
City	:	MOORESTOWN
State	:	NJ
Zip	:	08057-1009
Country	:	US
Telephone Number	:	856-273-6509
Fax Number	:

Provider Business Practice Location Address
First Line	:	9370 N ROUTE 130
Second Line	:	SUITE 200
City	:	PENNSAUKEN
State	:	NJ
Zip	:	08110-1375
Country	:	US
Telephone Number	:	856-662-0604
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/25/2006
Last Update Date	:	03/23/2015

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