Provider Demographics
NPI:1558386185
Name:BURROWS, LISA MARIE (MPT)
Entity Type:Individual
Prefix:MISS
First Name:LISA
Middle Name:MARIE
Last Name:BURROWS
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17650 SUMNER
Mailing Address - Street 2:
Mailing Address - City:REDFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48240-2175
Mailing Address - Country:US
Mailing Address - Phone:248-787-9932
Mailing Address - Fax:
Practice Address - Street 1:28100 GRAND RIVER AVE STE 210-S
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48336-5967
Practice Address - Country:US
Practice Address - Phone:248-471-8648
Practice Address - Fax:248-471-8781
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2018-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501012558225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist