Lisa M Back

NPI #1174781983 in Crystal River, Florida

Provider Information

NPI Number: 1174781983
Entity Type: Individual
Name: Lisa M Back
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapy Assistant
Enumeration Date: May 29, 2008
Last Updated: May 29, 2008

Practice Location

Address: 394 N SUNCOAST BLVD
Address 2: SUITE 40
City: Crystal River
State: Florida
ZIP Code: 34429-5466
Phone: (352) 795-6225

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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