Individual
LISA ANN TELLIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1760 E KEN PRATT BLVD STE 302, LONGMONT, CO 80504-5311
(303) 684-1900
(303) 267-4470
Mailing address
1760 E KEN PRATT BLVD STE 302, LONGMONT, CO 80504-5311
(303) 684-1900
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2605
CO
Other
Enumeration date
06/19/2008
Last updated
05/20/2023
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