Healthcare Provider Details

I. General information

NPI: 1205883683
Provider Name (Legal Business Name): LISA AROSARENA DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2006
Last Update Date: 05/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1777 SENTRY PKWY W
BLUE BELL PA
19422-2207
US

IV. Provider business mailing address

748 WHITETAIL CIR
KING OF PRUSSIA PA
19406-1529
US

V. Phone/Fax

Practice location:
  • Phone: 610-277-1100
  • Fax:
Mailing address:
  • Phone: 917-402-2406
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPT018056
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: