Provider Demographics
NPI:1568446623
Name:EYE, LISA RAE (PT)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:RAE
Last Name:EYE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:RAE
Other - Last Name:KARCHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSPT
Mailing Address - Street 1:PO BOX 152
Mailing Address - Street 2:
Mailing Address - City:HILLTOP
Mailing Address - State:WV
Mailing Address - Zip Code:25855-0152
Mailing Address - Country:US
Mailing Address - Phone:304-469-2966
Mailing Address - Fax:304-465-8551
Practice Address - Street 1:4000 OUTLOOK DRIVE
Practice Address - Street 2:
Practice Address - City:HURRICANE
Practice Address - State:WV
Practice Address - Zip Code:25526
Practice Address - Country:US
Practice Address - Phone:304-469-2966
Practice Address - Fax:304-465-8551
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-02
Last Update Date:2016-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV001722225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist