MRS. Lisa L Faulk, LMT

NPI #1811129240 in Waldo, Florida

Provider Information

NPI Number: 1811129240
Entity Type: Individual
Name: MRS. Lisa L Faulk, LMT
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Specialist
Credential: LMT
Enumeration Date: Aug 19, 2009
Last Updated: Aug 19, 2009

Practice Location

Address: 14020 NE COUNTY ROAD 1471
City: Waldo
State: Florida
ZIP Code: 32694-4504
Phone: (352) 468-3270

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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