Provider Demographics
NPI:1457367336
Name:MAINIER, LISA ANNE (PHD, DO)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:ANNE
Last Name:MAINIER
Suffix:
Gender:F
Credentials:PHD, DO
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:ANNE
Other - Last Name:MICHALSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:SALUS INTEGRATIVE MEDICINE, PC.
Mailing Address - Street 2:2545 WEST 26TH ST.
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16506
Mailing Address - Country:US
Mailing Address - Phone:814-923-4025
Mailing Address - Fax:814-746-4684
Practice Address - Street 1:SALUS INTEGRATIVE MEDICINE, PC.
Practice Address - Street 2:2545 WEST 26TH ST.
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16506
Practice Address - Country:US
Practice Address - Phone:814-923-4025
Practice Address - Fax:814-746-4684
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH010543207Q00000X
PAOS015423207QA0505X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine