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Lisa Ann Waugh, LMT
Sports Medicine (Neuromusculoskeletal Medicine) Physician in S Charleston, West Virginia
NPI 1053517011

Lisa Ann Waugh is a Sports Medicine (Neuromusculoskeletal Medicine) Physician based in St Albans, WV. Lisa Ann Waugh practices in S Charleston, WV and has the professional credentials of LMT. The NPI Number for Lisa Ann Waugh is 1053517011 and holds a License No. 0388 (West Virginia).

The current practice location address for Lisa Ann Waugh is 1109 Jefferson Rd, S Charleston, WV and can be reached out via phone at 304-610-7888.

Location: 1109 Jefferson Rd, S Charleston, WV, 25177
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1053517011
Provider Name
Lisa Ann Waugh
Credential
LMT
Provider Entity Type
Individual
Gender
Female
Address
1109 Jefferson Rd, S Charleston, WV, 25177
Phone Number
304-610-7888
Fax Number
Provider Enumeration Date
06/26/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
0388 01 WV LICENSE
institution
Provider Business Practice Location Address Details
Address
1109 Jefferson Rd
City
S Charleston
State
West Virginia
Zip
25309-9780
Phone Number
304-610-7888
Fax Number
person
Provider Business Mailing Address Details
Address
1109 Jefferson Rd
City
S Charleston
State
West Virginia
Zip
25309-9780
Phone Number
304-610-7888
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Neuromusculoskeletal Medicine, Sports Medicine
Speciality
-
Taxonomy
204C00000X
License No.
0388 (West Virginia)
Definition
Definition to come.
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