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General NPI Number Information
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NPI Number | 1902242845
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Entity Type | Individual
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Provider Name | LISA MARIE WAYBRIGHT PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 05/19/2013
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Last Update Date | 02/09/2022
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Provider Practice Location Address
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Address Line | 2220 EDWARD HOLLAND DR
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City | RICHMOND
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State | VA
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Zip | 23230-2519
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Country | US
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Telephone | 804-678-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 703 CLAYPOOL TER
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City | NORTH CHESTERFIELD
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State | VA
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Zip | 23236-2614
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Country | US
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Telephone | 804-310-7754
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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 | 2305207582
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License Number State | VA
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