Provider Demographics
NPI:1053071449
Name:ZINI VOLOCH, LISA (PTA)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:ZINI VOLOCH
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:K
Other - Last Name:ZINI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:200 RENAISSANCE DR STE 103
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16001-7612
Mailing Address - Country:US
Mailing Address - Phone:724-256-9606
Mailing Address - Fax:724-256-9609
Practice Address - Street 1:1701 3RD ST STE 4
Practice Address - Street 2:
Practice Address - City:BEAVER
Practice Address - State:PA
Practice Address - Zip Code:15009-2432
Practice Address - Country:US
Practice Address - Phone:878-207-2192
Practice Address - Fax:878-207-2193
Is Sole Proprietor?:No
Enumeration Date:2021-12-27
Last Update Date:2021-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATE012890225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant