Healthcare Provider Details

I. General information

NPI: 1457367336
Provider Name (Legal Business Name): LISA ANNE MAINIER PHD, D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LISA ANNE MICHALSKI D.O.

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 01/30/2024
Certification Date: 01/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

SALUS INTEGRATIVE MEDICINE, PC. 2545 WEST 26TH ST.
ERIE PA
16506
US

IV. Provider business mailing address

SALUS INTEGRATIVE MEDICINE, PC. 2545 WEST 26TH ST.
ERIE PA
16506
US

V. Phone/Fax

Practice location:
  • Phone: 814-923-4025
  • Fax: 814-746-4684
Mailing address:
  • Phone: 814-923-4025
  • Fax: 814-746-4684

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number010543
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberOS015423
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS015423
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: