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General NPI Number Information
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NPI Number | 1134938798
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Entity Type | Individual
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Provider Name | LISA ANN WEBER PTA
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Gender | Female
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Dates
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Enumeration Date | 01/07/2025
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Last Update Date | 01/07/2025
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Provider Practice Location Address
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Address Line | 17 COBBLE RD
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City | SALISBURY
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State | CT
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Zip | 06068-1501
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Country | US
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Telephone | 860-435-9851
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Fax |
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Provider Business Mailing Address
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Address Line | 405 W HILL RD
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City | NEW HARTFORD
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State | CT
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Zip | 06057-2418
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Country | US
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Telephone | 860-424-1460
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 001912
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License Number State | CT
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