Provider Demographics
NPI:1740524867
Name:ZEMAN, LISA MARIE (PT, MPT, CLT)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:MARIE
Last Name:ZEMAN
Suffix:
Gender:F
Credentials:PT, MPT, CLT
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:MARIE
Other - Last Name:OVERBY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHYSICAL THERAPIST
Mailing Address - Street 1:1000 SCHOOL ST NW STE 109
Mailing Address - Street 2:
Mailing Address - City:ELK RIVER
Mailing Address - State:MN
Mailing Address - Zip Code:55330-1337
Mailing Address - Country:US
Mailing Address - Phone:763-400-7438
Mailing Address - Fax:866-881-6769
Practice Address - Street 1:1000 SCHOOL ST NW STE 109
Practice Address - Street 2:
Practice Address - City:ELK RIVER
Practice Address - State:MN
Practice Address - Zip Code:55330-1337
Practice Address - Country:US
Practice Address - Phone:763-400-7438
Practice Address - Fax:866-881-6769
Is Sole Proprietor?:No
Enumeration Date:2012-11-15
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6527225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN071899OtherOPTUM (UNITED HEALTH CARE) PROVIDER ID