Provider Demographics
NPI:1669683652
Name:TUNNERA, LISA MARIE (PT)
Entity type:Individual
Prefix:MS
First Name:LISA
Middle Name:MARIE
Last Name:TUNNERA
Suffix:
Gender:
Credentials:PT
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:
Other - Last Name:KNOX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:59 AUTUMN CIR
Mailing Address - Street 2:
Mailing Address - City:HOLDEN
Mailing Address - State:MA
Mailing Address - Zip Code:01520-1488
Mailing Address - Country:US
Mailing Address - Phone:508-829-5898
Mailing Address - Fax:508-835-3643
Practice Address - Street 1:65 BOSTON POST RD W STE 130
Practice Address - Street 2:
Practice Address - City:MARLBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01752-1855
Practice Address - Country:US
Practice Address - Phone:508-481-5519
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6287225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist