Provider Demographics
NPI:1336261288
Name:MASON, LISA L (MPT)
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:L
Last Name:MASON
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:MRS
Other - First Name:LISA
Other - Middle Name:L
Other - Last Name:MACK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT
Mailing Address - Street 1:725 CHERRINGTON PKWY
Mailing Address - Street 2:SUITE 201
Mailing Address - City:MOON TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:15108-4318
Mailing Address - Country:US
Mailing Address - Phone:412-264-6192
Mailing Address - Fax:412-264-6196
Practice Address - Street 1:725 CHERRINGTON PKWY
Practice Address - Street 2:SUITE 201
Practice Address - City:MOON TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:15108-4318
Practice Address - Country:US
Practice Address - Phone:412-264-6192
Practice Address - Fax:412-264-6196
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2012-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADAP000706225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist