Basic Information
| Provider Information | |||||||||
| NPI: | 1568446623 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | EYE | ||||||||
| FirstName: | LISA | ||||||||
| MiddleName: | RAE | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PT | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | KARCHER | ||||||||
| OtherFirstName: | LISA | ||||||||
| OtherMiddleName: | RAE | ||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | MSPT | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | PO BOX 152 | ||||||||
| Address2: | |||||||||
| City: | HILLTOP | ||||||||
| State: | WV | ||||||||
| PostalCode: | 258550152 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3044692966 | ||||||||
| FaxNumber: | 3044658551 | ||||||||
| Practice Location | |||||||||
| Address1: | 4000 OUTLOOK DRIVE | ||||||||
| Address2: | |||||||||
| City: | HURRICANE | ||||||||
| State: | WV | ||||||||
| PostalCode: | 25526 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3044692966 | ||||||||
| FaxNumber: | 3044658551 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/02/2005 | ||||||||
| LastUpdateDate: | 07/19/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 001722 | WV | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.