Provider Demographics
NPI:1740695329
Name:SCHAEFER, LISA MANNING (MPT)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:MANNING
Last Name:SCHAEFER
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27056 ANDREW JACKSON HWY E
Mailing Address - Street 2:SUITE 2
Mailing Address - City:DELCO
Mailing Address - State:NC
Mailing Address - Zip Code:28436-8200
Mailing Address - Country:US
Mailing Address - Phone:910-679-3212
Mailing Address - Fax:877-752-0751
Practice Address - Street 1:27056 ANDREW JACKSON HWY E
Practice Address - Street 2:SUITE 2
Practice Address - City:DELCO
Practice Address - State:NC
Practice Address - Zip Code:28436-8200
Practice Address - Country:US
Practice Address - Phone:910-679-3212
Practice Address - Fax:877-752-0751
Is Sole Proprietor?:No
Enumeration Date:2014-06-23
Last Update Date:2014-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP5094225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist