Spencer, Lisa

Spencer, Lisa is an sole proprietor health care provider with primary practice located at 2401 W Main St , Marion IL 62959-1188. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / General Care, which is considered as her primary health care specialty. Spencer, Lisa can be contacted via phone (618) 997-5311.

Contact Information

Primary practice address
2401 W Main St Marion IL 62959-1188
Phone: (618) 997-5311
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / General Care 2279G1100X 194006771 Illinois

Profile Details

NPI number 1376893628
LBN Legal business name Spencer, Lisa
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 13th, 2012
Last updated Sep 13th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376893628 NPPES
Other 194006771 NBRC

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