Provider Demographics
NPI:1396094025
Name:TOMLINSON, LISA (PTA)
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:
Last Name:TOMLINSON
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:LEANN
Other - Last Name:QUICK HEDRICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:116 HILLCREST ST
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:MO
Mailing Address - Zip Code:64601-3624
Mailing Address - Country:US
Mailing Address - Phone:816-590-1598
Mailing Address - Fax:
Practice Address - Street 1:116 HILLCREST ST
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:MO
Practice Address - Zip Code:64601-3624
Practice Address - Country:US
Practice Address - Phone:816-590-1598
Practice Address - Fax:660-258-1025
Is Sole Proprietor?:No
Enumeration Date:2012-09-10
Last Update Date:2015-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2008025808225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant