MEDICARE: MISS LISA HILL PHYSICAL THERAPIST

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	PT13749	CA

General Provider Information

NPI Number	:	1730266131
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS LISA HILL PHYSICAL THERAPIST

Provider Business Mailing Address
First Line	:	777 FLOWER ST STE A
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91201-3000
Country	:	US
Telephone Number	:	818-637-2000
Fax Number	:	818-242-8761

Provider Business Practice Location Address
First Line	:	101 S 1ST ST
Second Line	:	STE 1800
City	:	BURBANK
State	:	CA
Zip	:	91502-1938
Country	:	US
Telephone Number	:	818-558-7252
Fax Number	:	818-558-7312

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

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	05/18/2011

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