Provider Demographics
NPI:1972620003
Name:CULLEN, LISA (PT)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:CULLEN
Suffix:
Gender:
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 BRIDLE LN
Mailing Address - Street 2:
Mailing Address - City:SOUTH EASTON
Mailing Address - State:MA
Mailing Address - Zip Code:02375-1404
Mailing Address - Country:US
Mailing Address - Phone:508-238-7897
Mailing Address - Fax:
Practice Address - Street 1:50 OLIVER ST
Practice Address - Street 2:SUITE W-2B
Practice Address - City:NORTH EASTON
Practice Address - State:MA
Practice Address - Zip Code:02356-1446
Practice Address - Country:US
Practice Address - Phone:508-682-0186
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2025-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8456225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist