Provider Demographics
NPI:1760599245
Name:HOYT, LISA ROSE (LPT)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:ROSE
Last Name:HOYT
Suffix:
Gender:F
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4065
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27836-2065
Mailing Address - Country:US
Mailing Address - Phone:252-215-9119
Mailing Address - Fax:252-215-9121
Practice Address - Street 1:2430 CHARLES BLVD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-5924
Practice Address - Country:US
Practice Address - Phone:252-215-9119
Practice Address - Fax:252-215-9121
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2004225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC079EJOtherBLUECROSS BLUESHIELD
NC56162OtherMEDCOST
NC079EJOtherBLUECROSS BLUESHIELD