Provider Demographics
NPI:1710037908
Name:SPRINGER, LISA JO (PT)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:JO
Last Name:SPRINGER
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 1:16141 SWINGLEY RIDGE RD STE 210
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-1780
Mailing Address - Country:US
Mailing Address - Phone:901-573-5306
Mailing Address - Fax:
Practice Address - Street 1:16141 SWINGLEY RIDGE RD STE 210
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-1780
Practice Address - Country:US
Practice Address - Phone:901-573-5306
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001020608225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO431775902SPROtherMERCY
MO120764OtherBCBS
MO481617OtherHEALTHLINK
MO150900021Medicare PIN
MO120764OtherBCBS
MO266641Medicare Oscar/Certification