Basic Information
Provider Information
NPI: 1033459946
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: VOGEL
FirstName: LISA
MiddleName: ANNE
NamePrefix:  
NameSuffix:  
Credential: DPT
OtherOrganizationName:  
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OtherLastName:  
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Mailing Information
Address1: 800 CRESCENT CENTRE DR
Address2: SUITE 600
City: FRANKLIN
State: TN
PostalCode: 370677269
CountryCode: US
TelephoneNumber: 6153731350
FaxNumber: 6152219054
Practice Location
Address1: 750 COLONIAL PROMENADE PKWY
Address2: SUITE 4400
City: ALABASTER
State: AL
PostalCode: 350073142
CountryCode: US
TelephoneNumber: 2053581040
FaxNumber: 2053581041
Other Information
ProviderEnumerationDate: 03/01/2013
LastUpdateDate: 01/15/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/15/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000XPTH6741ALY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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