Individual
MS. LISA MARIE AANONSEN KELLOGG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
374 SOPRIS CIR, BASALT, CO 81621-8373
(970) 456-3612
Mailing address
PO BOX 589, BASALT, CO 81621-0589
(970) 456-3612
(970) 312-8032
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
7897
CO
Other
Enumeration date
09/05/2007
Last updated
08/23/2021
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