Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | 2095958 | TX |
NPI | 1013465574 |
---|---|
Provider Name | Lisa Noseff |
First Address | Lubbock, TX 79423-1422 |
Second Address | Lubbock, TX 79423-1422 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2016 |
Last Update Date | 13/09/2016 |