Provider Demographics
NPI:1669683652
Name:KNOX, LISA MARIE (PT)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:MARIE
Last Name:KNOX
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:59 AUTUMN CIR
Mailing Address - Street 2:
Mailing Address - City:HOLDEN
Mailing Address - State:MA
Mailing Address - Zip Code:01520-1488
Mailing Address - Country:US
Mailing Address - Phone:508-829-5898
Mailing Address - Fax:508-835-3643
Practice Address - Street 1:140 WORCESTER ST
Practice Address - Street 2:
Practice Address - City:WEST BOYLSTON
Practice Address - State:MA
Practice Address - Zip Code:01583-1716
Practice Address - Country:US
Practice Address - Phone:508-835-3273
Practice Address - Fax:508-835-3643
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6287225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist