Provider Demographics
NPI:1770824047
Name:MORRISON, LISA L (DPT)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:L
Last Name:MORRISON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3277 E LOUISE DR
Mailing Address - Street 2:SUITE 350
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83642-9359
Mailing Address - Country:US
Mailing Address - Phone:208-887-9500
Mailing Address - Fax:208-887-9800
Practice Address - Street 1:3277 E LOUISE DR
Practice Address - Street 2:SUITE 350
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83642-9359
Practice Address - Country:US
Practice Address - Phone:208-887-9500
Practice Address - Fax:208-887-9800
Is Sole Proprietor?:No
Enumeration Date:2013-03-11
Last Update Date:2013-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDPT-1830225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist