Most Relevant Information
Provider Data
| NPI Number: | 1003826785 |
| Provider Name: | LISA M OLDHAM |
| Entity Type: | Individual |
| Taxonomy Code: | 225100000X |
| Specialty: | Physical Therapist |
| License Number: | 05005647 |
Most Important Dates
| Enumeration Date: | 08/08/2006 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
1701 SENATE BLVD
SUITE AG045
INDIANAPOLIS
IN
462021239
Practice Location Phone/Fax
| Phone: | 3179624836 |
| Fax: | 3179624812 |
Provider Mailing Location
950 N MERIDIAN ST
SUITE 300
INDIANAPOLIS
IN
462041077
Provider Mailing Phone/Fax
| Phone: | 3179624836 |
| Fax: | 3179624812 |