Weathers, Lisa A

Weathers, Lisa A is an sole proprietor health care provider with primary practice located at 1707 S Colorado St Suite A, Greenville MS 38703-7275. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Sports, which is considered as her primary health care specialty. Weathers, Lisa A can be contacted via phone (662) 335-8332.

Contact Information

Primary practice address
1707 S Colorado St Suite A Greenville MS 38703-7275
Phone: (662) 335-8332
Fax: (662) 335-8852
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Sports 2251S0007X PT4686 Mississippi

Profile Details

NPI number 1598085730
LBN Legal business name Weathers, Lisa A
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 10th, 2010
Last updated Jun 10th, 2010 - about 15 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 1598085730 NPPES
Mississippi MEDICAID 09015486
Mississippi Other 640925683

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