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General NPI Number Information
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NPI Number | 1710092028
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Entity Type | Individual
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Provider Name | LISA HEDIEN RPT
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Gender | Female
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Dates
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Enumeration Date | 08/20/2006
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Last Update Date | 02/09/2025
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Provider Practice Location Address
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Address Line | 13951 W GRAND AVE
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City | SURPRISE
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State | AZ
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Zip | 85374-2436
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Country | US
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Telephone | 623-537-9730
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Fax |
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Provider Business Mailing Address
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Address Line | 15621 W SKY HAWK DR
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City | SUN CITY WEST
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State | AZ
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Zip | 85375-6514
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Country | US
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Telephone | 310-469-1178
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT26401
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | LPT-32597
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License Number State | AZ
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