Provider Demographics
NPI:1013268150
Name:BROWN, LISA M (MS, LAC)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:M
Last Name:BROWN
Suffix:
Gender:F
Credentials:MS, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3009 WESTERN BLUFFS BLVD
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59106-2209
Mailing Address - Country:US
Mailing Address - Phone:925-787-0577
Mailing Address - Fax:406-534-2628
Practice Address - Street 1:3009 WESTERN BLUFFS BLVD
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59106-2209
Practice Address - Country:US
Practice Address - Phone:925-787-0577
Practice Address - Fax:406-534-2628
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-28
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14729171100000X
MT28700171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist