Healthcare Provider Details

I. General information

NPI: 1730266131
Provider Name (Legal Business Name): LISA HILL PHYSICAL THERAPIST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 05/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 S 1ST ST STE 1800
BURBANK CA
91502-1938
US

IV. Provider business mailing address

777 FLOWER ST STE A
GLENDALE CA
91201-3000
US

V. Phone/Fax

Practice location:
  • Phone: 818-558-7252
  • Fax: 818-558-7312
Mailing address:
  • Phone: 818-637-2000
  • Fax: 818-242-8761

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT13749
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: