Individual
MISS LISA ERIN DEBORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
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
Update your record
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