Provider Demographics
NPI:1174569388
Name:NEUMAN, LISA (PT)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:NEUMAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 33RD ST S STE 210
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56301-9668
Mailing Address - Country:US
Mailing Address - Phone:320-240-6955
Mailing Address - Fax:320-240-8089
Practice Address - Street 1:251 COUNTY ROAD 120
Practice Address - Street 2:SUITE A
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303
Practice Address - Country:US
Practice Address - Phone:320-259-5429
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6517225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNHP30272OtherHEALTHPARTNERS
MN6400654OtherMEDICA
MN323667600Medicaid
MN52B61KIOtherBCBS
MN6400654OtherSELECT CARE
MN264M1NOOtherBLUE CROSS BLUE SHIELD OF MN
MN6400654OtherSELECT CARE
MN323667600Medicaid
MN650002088Medicare PIN