Lisa Elaine Burdick, PTA
Individual provider Active NPI Physical Therapy Assistant · Raymore, MO
NPI 1992048920 · NPPES record last updated Mar 27, 2013
Key facts
- NPI
- 1992048920
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 2012025586 (MO)
- Practice address
- 702 Magnolia St
Raymore, MO 64083-9353 - Phone
- (816) 678-6584
- NPI assigned
- Mar 27, 2013
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2012025586 | MO | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 2012025586 | MO | Yes |
Addresses
Primary practice location
702 Magnolia St
Raymore, MO 64083-9353
Mailing address
702 Magnolia St
Raymore, MO 64083-9353
Phone (816) 678-6584
Other providers in Raymore, MO
- Jasmyne Renee' Brown
- Julie D Broyle
- Irene Broyles
- Bryan Huff O.D., P.C
- Kember Lee Ann Buhman
- Burleson Orthodontics and Pediatric Dentistry, LLC
- Janet Lynn Burns
- Kerry Alice Chrysalis Bursley
- Deanna Lee Campbell
- Cantrell Chiropractic
All providers in Raymore, MO · Physical Therapy Assistant in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 27, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.