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General NPI Number Information
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NPI Number | 1811977101
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Entity Type | Individual
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Provider Name | LISA E STAUDT D.C.
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Gender | Female
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Dates
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Enumeration Date | 01/20/2006
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Last Update Date | 06/03/2008
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Provider Practice Location Address
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Address Line | 1225 PAPILLION DR
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City | PAPILLION
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State | NE
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Zip | 68046-5708
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Country | US
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Telephone | 402-593-9930
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Fax | 402-593-0310
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Provider Business Mailing Address
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Address Line | 7808 MAUI CIR
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City | PAPILLION
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State | NE
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Zip | 68046-5644
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Country | US
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Telephone | 402-339-8188
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Fax | 402-593-0310
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 1152
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License Number State | NE
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