Provider Demographics
NPI:1982823605
Name:JURSKI, LISA MARGARET W (PT)
Entity Type:Individual
Prefix:
First Name:LISA MARGARET
Middle Name:W
Last Name:JURSKI
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2207 HANCOCK DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78756-2508
Mailing Address - Country:US
Mailing Address - Phone:312-339-7269
Mailing Address - Fax:312-782-1840
Practice Address - Street 1:2207 HANCOCK DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78756-2508
Practice Address - Country:US
Practice Address - Phone:312-339-7269
Practice Address - Fax:312-782-1840
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070011657225100000X
TX1354057225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist