Provider Demographics
NPI:1154607380
Name:THURSBY, LISA D
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:D
Last Name:THURSBY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8701 HOLMES RD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64131-2802
Mailing Address - Country:US
Mailing Address - Phone:816-349-3300
Mailing Address - Fax:816-349-3431
Practice Address - Street 1:8701 HOLMES RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64131-2802
Practice Address - Country:US
Practice Address - Phone:816-349-3300
Practice Address - Fax:816-349-3431
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-02
Last Update Date:2011-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR1009225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist