Individual
LARAINNA JO LIVELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5815 MARK DABLING BLVD, COLORADO SPRINGS, CO 80919-2231
(719) 413-8061
Mailing address
5815 MARK DABLING BLVD, COLORADO SPRINGS, CO 80919-2231
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
12370
SC
225100000X
Physical Therapist
CP045035T
CO
Other
Enumeration date
11/05/2025
Last updated
11/05/2025
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