Individual
LISA MARIE PRATHER ROLLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1601 E BROADWAY STE 240, COLUMBIA, MO 65201-8022
(573) 815-8145
(573) 815-3832
Mailing address
1601 E BROADWAY STE 240, COLUMBIA, MO 65201-8022
(573) 815-8145
(573) 815-3832
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
2011014242
MO
Other
Enumeration date
07/10/2008
Last updated
02/21/2020
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