Healthcare Provider Details

I. General information

NPI: 1689659633
Provider Name (Legal Business Name): LISA PERKINS HOUCK PT, DPT, OCS, MTC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LISA MICHELE PERKINS PT, DPT, OCS, MTC

II. Dates (important events)

Enumeration Date: 12/13/2005
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

610 SOLAREX CT
FREDERICK MD
21703-8624
US

IV. Provider business mailing address

610 SOLAREX CT
FREDERICK MD
21703-8624
US

V. Phone/Fax

Practice location:
  • Phone: 240-215-9023
  • Fax: 240-215-9026
Mailing address:
  • Phone: 240-215-9023
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number20195
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: