MEDICARE: LISA STROBEL

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
1	225100000X	Physical Therapist	PT008452L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1019433450001	OTHER	PA	MEDICAL ASSISTANCE

General Provider Information

NPI Number	:	1083805329
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA STROBEL

Provider Business Mailing Address
First Line	:	15 ABBEY LN
Second Line	:
City	:	WYOMING
State	:	PA
Zip	:	18644-9100
Country	:	US
Telephone Number	:	570-674-7963
Fax Number	:	570-674-7934

Provider Business Practice Location Address
First Line	:	RR 3 BOX 178B
Second Line	:
City	:	HARVEYS LAKE
State	:	PA
Zip	:	18618-9404
Country	:	US
Telephone Number	:	570-674-7963
Fax Number	:	570-674-7934

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/01/2007
Last Update Date	:	08/01/2007

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Directions to “ LISA STROBEL ” Practice Location

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