Provider Demographics
NPI:1578579629
Name:PAULUS, LISA M (MS PT)
Entity Type:Individual
Prefix:MISS
First Name:LISA
Middle Name:M
Last Name:PAULUS
Suffix:
Gender:F
Credentials:MS PT
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Mailing Address - Street 1:23091 E MAIN ST STE E
Mailing Address - Street 2:
Mailing Address - City:ARMADA
Mailing Address - State:MI
Mailing Address - Zip Code:48005-4706
Mailing Address - Country:US
Mailing Address - Phone:586-784-6004
Mailing Address - Fax:586-784-6009
Practice Address - Street 1:23091 E MAIN ST STE E
Practice Address - Street 2:
Practice Address - City:ARMADA
Practice Address - State:MI
Practice Address - Zip Code:48005-4706
Practice Address - Country:US
Practice Address - Phone:586-784-6004
Practice Address - Fax:586-784-6009
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2022-07-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI5501005571225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist