Provider Demographics
NPI:1760641971
Name:CUMMINGS, LISA MARION (LPTA)
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:MARION
Last Name:CUMMINGS
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:634 TAYLOR AVE
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18510-1817
Mailing Address - Country:US
Mailing Address - Phone:570-941-9449
Mailing Address - Fax:
Practice Address - Street 1:1101 VINE ST
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18510-2126
Practice Address - Country:US
Practice Address - Phone:570-343-7175
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-03
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATE000459L225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant