MEDICARE: LISA ELDER LMT

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	225700000X	Massage Therapist	MSG002137	PA

General Provider Information

NPI Number	:	1912864455
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA ELDER LMT

Provider Business Mailing Address
First Line	:	300 W SOUTHEY AVE
Second Line	:
City	:	ALTOONA
State	:	PA
Zip	:	16602-3023
Country	:	US
Telephone Number	:	814-327-3078
Fax Number	:

Provider Business Practice Location Address
First Line	:	121 UNION AVENUE
Second Line	:
City	:	ALTOONA
State	:	PA
Zip	:	16602
Country	:	US
Telephone Number	:	814-327-3078
Fax Number	:

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

Provider Enumeration Date	:	01/07/2026
Last Update Date	:	01/07/2026

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Directions to “ LISA ELDER LMT” Practice Location

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