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Individual

MISS LISA ERIN DEBORD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
301 E LINCOLN AVE, FORT COLLINS, CO 80524-2505
(970) 818-0060
(970) 498-4645
Mailing address
234 BISHOP ST, FORT COLLINS, CO 80521-1708
(970) 818-0060
(970) 549-8464

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
1125
WY
225100000X
Physical Therapist
Primary
8810
CO
225100000X
Physical Therapist
9370
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
8810
COLORADO LICENSE
CO
Enumeration date
05/22/2007
Last updated
06/11/2019
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