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NPI Code Detail

MEDICARE: DR. LISA S TOBUREN PHD

MEDICARE:  DR. LISA S TOBUREN  PHD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103T00000XPsychologist2333KS

General Provider Information

NPI Number : 1053506717
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LISA S TOBUREN PHD
Provider Business Mailing Address
First Line : 720 POYNTZ AVE
Second Line :
City : MANHATTAN
State : KS
Zip : 66502-6355
Country : US
Telephone Number : 785-320-7331
Fax Number :
Provider Business Practice Location Address
First Line : 720 POYNTZ AVE
Second Line :
City : MANHATTAN
State : KS
Zip : 66502-6355
Country : US
Telephone Number : 785-320-7331
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/06/2007
Last Update Date : 01/07/2016

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Directions to “ DR. LISA S TOBUREN PHD” Practice Location

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