Provider Demographics
NPI:1215199880
Name:BARNETT, LISA A (DPT)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:A
Last Name:BARNETT
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3142 BROADWAY
Mailing Address - Street 2:SUITE 206
Mailing Address - City:GROVE CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43123-1780
Mailing Address - Country:US
Mailing Address - Phone:614-875-9100
Mailing Address - Fax:614-875-9145
Practice Address - Street 1:3142 BROADWAY
Practice Address - Street 2:SUITE 206
Practice Address - City:GROVE CITY
Practice Address - State:OH
Practice Address - Zip Code:43123-1780
Practice Address - Country:US
Practice Address - Phone:614-875-9100
Practice Address - Fax:614-875-9145
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-25
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH100822251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics