MEDICARE: MS. LISA M FOX PT, CSCS, CPI

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	6973	TN

General Provider Information

NPI Number	:	1487629895
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LISA M FOX PT, CSCS, CPI

Provider Business Mailing Address
First Line	:	516 TREMONT ST
Second Line	:
City	:	CHATTANOOGA
State	:	TN
Zip	:	37405-4153
Country	:	US
Telephone Number	:	423-756-4781
Fax Number	:	423-756-4782

Provider Business Practice Location Address
First Line	:	516 TREMONT ST
Second Line	:
City	:	CHATTANOOGA
State	:	TN
Zip	:	37405-4153
Country	:	US
Telephone Number	:	423-756-4781
Fax Number	:	423-756-4782

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

Provider Enumeration Date	:	02/20/2006
Last Update Date	:	07/08/2007

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