Healthcare Provider Details

I. General information

NPI: 1336105857
Provider Name (Legal Business Name): LISA A CALASANT P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LISA A PICKETT PT

II. Dates (important events)

Enumeration Date: 04/24/2006
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

421 SQUIRE POPE RD
HILTON HEAD ISLAND SC
29926-1229
US

IV. Provider business mailing address

PO BOX 504469
SAINT LOUIS MO
63150-4469
US

V. Phone/Fax

Practice location:
  • Phone: 843-342-4086
  • Fax: 502-212-8450
Mailing address:
  • Phone: 800-969-9265
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT10181
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: