Provider Demographics
NPI:1932461118
Name:HUNSTIGER, LISA ANN
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:ANN
Last Name:HUNSTIGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 RED RIVER AVE S
Mailing Address - Street 2:SUITE 100
Mailing Address - City:COLD SPRING
Mailing Address - State:MN
Mailing Address - Zip Code:56320-4590
Mailing Address - Country:US
Mailing Address - Phone:320-685-4006
Mailing Address - Fax:320-685-4116
Practice Address - Street 1:20 RED RIVER AVE S
Practice Address - Street 2:SUITE 100
Practice Address - City:COLD SPRING
Practice Address - State:MN
Practice Address - Zip Code:56320-4590
Practice Address - Country:US
Practice Address - Phone:320-685-4006
Practice Address - Fax:320-685-4116
Is Sole Proprietor?:No
Enumeration Date:2012-06-13
Last Update Date:2012-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist