Provider Demographics
NPI:1780063719
Name:STORY, LISA LYNN (PTA, LMT, NSCA-CPT)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:LYNN
Last Name:STORY
Suffix:
Gender:F
Credentials:PTA, LMT, NSCA-CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 L. ST. NW
Mailing Address - Street 2:SUITE 607
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036
Mailing Address - Country:US
Mailing Address - Phone:202-528-7223
Mailing Address - Fax:202-293-2262
Practice Address - Street 1:1900 L. ST. NW
Practice Address - Street 2:SUITE 607
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036
Practice Address - Country:US
Practice Address - Phone:202-528-7223
Practice Address - Fax:202-293-2262
Is Sole Proprietor?:No
Enumeration Date:2015-05-22
Last Update Date:2015-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant