Provider Demographics
NPI:1033777008
Name:CATAROUCHE, LISA RENEE (PTA)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:RENEE
Last Name:CATAROUCHE
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 1/2 CLEVELAND ST
Mailing Address - Street 2:
Mailing Address - City:PUNXSUTAWNEY
Mailing Address - State:PA
Mailing Address - Zip Code:15767-1830
Mailing Address - Country:US
Mailing Address - Phone:814-938-2181
Mailing Address - Fax:
Practice Address - Street 1:302 1/2 CLEVELAND ST
Practice Address - Street 2:
Practice Address - City:PUNXSUTAWNEY
Practice Address - State:PA
Practice Address - Zip Code:15767-1830
Practice Address - Country:US
Practice Address - Phone:814-938-2181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-04
Last Update Date:2019-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATEI000945225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant