Provider Demographics
NPI:1326873332
Name:HOLLISTER, LISA K (PT)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:K
Last Name:HOLLISTER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 SHEARER RD
Mailing Address - Street 2:
Mailing Address - City:COLRAIN
Mailing Address - State:MA
Mailing Address - Zip Code:01340-9777
Mailing Address - Country:US
Mailing Address - Phone:413-824-6239
Mailing Address - Fax:
Practice Address - Street 1:267 AMHERST RD
Practice Address - Street 2:
Practice Address - City:SUNDERLAND
Practice Address - State:MA
Practice Address - Zip Code:01375-9614
Practice Address - Country:US
Practice Address - Phone:508-434-2360
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-09
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics