Provider Demographics
NPI:1003284910
Name:GUALTIERI, LISA (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:GUALTIERI
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91 RAMBLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:GLENMOORE
Mailing Address - State:PA
Mailing Address - Zip Code:19343-1140
Mailing Address - Country:US
Mailing Address - Phone:484-888-0627
Mailing Address - Fax:
Practice Address - Street 1:300 STRODE AVE
Practice Address - Street 2:
Practice Address - City:EAST FALLOWFIELD TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:19320-2874
Practice Address - Country:US
Practice Address - Phone:610-384-6310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-09
Last Update Date:2015-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT007925L2251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics