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General NPI Number Information
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NPI Number | 1043412083
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Entity Type | Individual
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Provider Name | LISA MARIE SYMONS OTR
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Gender | Female
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Dates
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Enumeration Date | 06/01/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 371 BETHEL CHURCH RD
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City | LIGONIER
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State | PA
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Zip | 15658-2074
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Country | US
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Telephone | 724-593-7447
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Fax |
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Provider Business Mailing Address
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Address Line | 117 CANDLE RIDGE DR
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City | WEXFORD
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State | PA
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Zip | 15090-7104
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Country | US
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Telephone | 724-933-0214
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | OC004838L
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License Number State | PA
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