Provider Demographics
NPI:1639235740
Name:FLAMING, LISA A (PT)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:A
Last Name:FLAMING
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2318 VIRGINIA LN
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-2505
Mailing Address - Country:US
Mailing Address - Phone:406-252-0717
Mailing Address - Fax:
Practice Address - Street 1:2318 VIRGINIA LN
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-2505
Practice Address - Country:US
Practice Address - Phone:406-252-0717
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT511174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist