Provider Demographics
NPI:1083884431
Name:TORMO, LISA L (RPT)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:L
Last Name:TORMO
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 NORDIC WAY
Mailing Address - Street 2:
Mailing Address - City:MELROSE
Mailing Address - State:MA
Mailing Address - Zip Code:02176-6513
Mailing Address - Country:US
Mailing Address - Phone:781-662-1101
Mailing Address - Fax:
Practice Address - Street 1:10 NORDIC WAY
Practice Address - Street 2:
Practice Address - City:MELROSE
Practice Address - State:MA
Practice Address - Zip Code:02176-6513
Practice Address - Country:US
Practice Address - Phone:781-662-1101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-01
Last Update Date:2008-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8657225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist