Provider Demographics
NPI:1013755057
Name:MAYFIELD, LISA R (BA, LNMT, LMT)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:R
Last Name:MAYFIELD
Suffix:
Gender:F
Credentials:BA, LNMT, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:932 HENDERSONVILLE RD STE 105
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-1733
Mailing Address - Country:US
Mailing Address - Phone:828-338-8273
Mailing Address - Fax:
Practice Address - Street 1:932 HENDERSONVILLE RD STE 105
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-1733
Practice Address - Country:US
Practice Address - Phone:828-338-8273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-15
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10836204C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports MedicineGroup - Single Specialty