Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | 40QB00143600 | NJ |
NPI | 1003987603 |
---|---|
Provider Name | Lisa M Ames |
First Address | Jackson, NJ 08527-2236 |
Second Address | Jackson, NJ 08527-1241 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2006 |
Last Update Date | 05/11/2014 |