Provider Demographics
NPI:1902005226
Name:SPEER-HUET, LISA CATHLEEN (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:CATHLEEN
Last Name:SPEER-HUET
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:MISS
Other - First Name:LISA
Other - Middle Name:CATHLEEN
Other - Last Name:SPEER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHYSICAL THERAPIST
Mailing Address - Street 1:1657 NORSTAR LN
Mailing Address - Street 2:
Mailing Address - City:FALLBROOK
Mailing Address - State:CA
Mailing Address - Zip Code:92028-9573
Mailing Address - Country:US
Mailing Address - Phone:760-731-8965
Mailing Address - Fax:
Practice Address - Street 1:1657 NORSTAR LN
Practice Address - Street 2:
Practice Address - City:FALLBROOK
Practice Address - State:CA
Practice Address - Zip Code:92028-9573
Practice Address - Country:US
Practice Address - Phone:760-731-8965
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-17
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33324225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist