Provider Demographics
NPI:1942895248
Name:LISONBEE, CHERYLEE (DC)
Entity Type:Individual
Prefix:
First Name:CHERYLEE
Middle Name:
Last Name:LISONBEE
Suffix:
Gender:F
Credentials:DC
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 977
Mailing Address - Street 2:
Mailing Address - City:PINEDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85934-0977
Mailing Address - Country:US
Mailing Address - Phone:928-739-4124
Mailing Address - Fax:
Practice Address - Street 1:708 E DEUCE OF CLUBS
Practice Address - Street 2:
Practice Address - City:SHOW LOW
Practice Address - State:AZ
Practice Address - Zip Code:85901-4942
Practice Address - Country:US
Practice Address - Phone:928-242-4389
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-08
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4324111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor