Provider Demographics
NPI:1649810532
Name:KALITKA, LISA (PT, DPT)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:KALITKA
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3745 SHAWNEE RD STE 103
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45806-1660
Mailing Address - Country:US
Mailing Address - Phone:419-216-9913
Mailing Address - Fax:567-301-3703
Practice Address - Street 1:22 W OGLETHORPE AVE
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31401-3702
Practice Address - Country:US
Practice Address - Phone:419-216-9913
Practice Address - Fax:567-301-3703
Is Sole Proprietor?:No
Enumeration Date:2020-01-08
Last Update Date:2025-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT015005225100000X
225100000X
SCCP024799T225100000X
NCCP024798T225100000X
FLPT40908225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist