Provider Demographics
NPI:1801830781
Name:LAWSON, LISA V (PT)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:V
Last Name:LAWSON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:
Other - Last Name:VAN HORN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:119 N DOW ST
Mailing Address - Street 2:
Mailing Address - City:FALCONER
Mailing Address - State:NY
Mailing Address - Zip Code:14733-1509
Mailing Address - Country:US
Mailing Address - Phone:716-488-2322
Mailing Address - Fax:716-488-2574
Practice Address - Street 1:15 SOUTH MAIN STREET
Practice Address - Street 2:SUITE 220
Practice Address - City:JAMESTOWN
Practice Address - State:NY
Practice Address - Zip Code:14701
Practice Address - Country:US
Practice Address - Phone:716-488-2322
Practice Address - Fax:716-488-2574
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2013-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0045531225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist