Lisa Glaser, MS, PT

Individual provider Active NPI Physical Therapist · McClellan, CA

NPI 1588053383 · NPPES record last updated Jan 16, 2015

Key facts

NPI
1588053383
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
34729 (CA)
Practice address
5342 Dudley Blvd BLDG 98
McClellan, CA 95652-1012
Phone
(916) 561-7510
NPI assigned
Jan 16, 2015
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
34729CAMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 34729 CA Yes

Addresses

Primary practice location

5342 Dudley Blvd BLDG 98
McClellan, CA 95652-1012

Mailing address

5342 Dudley Blvd BLDG 98
McClellan, CA 95652-1012
Phone (916) 561-7510

Other providers in McClellan, CA

All providers in McClellan, CA · Physical Therapist in California

Sources for this page

Verify at the official NPI Registry.