Provider Demographics
NPI:1689795767
Name:MADIGAN-CAREY, LISA S (PT)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:S
Last Name:MADIGAN-CAREY
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 1:8965 GUILFORD RD STE 160
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21046-2396
Mailing Address - Country:US
Mailing Address - Phone:410-474-4397
Mailing Address - Fax:
Practice Address - Street 1:8965 GUILFORD RD STE 160
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-2396
Practice Address - Country:US
Practice Address - Phone:410-474-4397
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2008-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD21203225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist