Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251E1200X | Ergonomics | 5201008290 | MI |
Y | 225XE1200X | Ergonomics | 5201008290 | MI |
NPI | 1154763647 |
---|---|
Provider Name | Lisa Fitzpatrick |
First Address | Traverse City, MI 49686-9249 |
Second Address | Traverse City, MI 49686-9249 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2013 |
Last Update Date | 24/07/2013 |