Individual
DR. MATTHEW J LISENBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
2770 WOODGATE RD, MONTROSE, CO 81401-5466
(970) 249-2330
(970) 249-6131
Mailing address
2770 WOODGATE RD, MONTROSE, CO 81401-5466
(970) 249-2330
(970) 249-6131
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2792
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
19674244
—
CO
Enumeration date
01/27/2011
Last updated
12/29/2020
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