Provider Demographics
NPI:1215365614
Name:DOYLE, LISA (PT, MS)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:DOYLE
Suffix:
Gender:F
Credentials:PT, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 CLEVELAND AVE
Mailing Address - Street 2:
Mailing Address - City:BRAINTREE
Mailing Address - State:MA
Mailing Address - Zip Code:02184-4846
Mailing Address - Country:US
Mailing Address - Phone:781-864-4835
Mailing Address - Fax:
Practice Address - Street 1:670 N COMMERCIAL ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03101-1160
Practice Address - Country:US
Practice Address - Phone:603-647-3500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-22
Last Update Date:2013-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7447225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist