Individual
LISA KENNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8580 SCARBOROUGH DR, SUITE 125, COLORADO SPRINGS, CO 80920-7583
(719) 282-1211
Mailing address
8076 FALLGOLD CT, COLORADO SPRINGS, CO 80927-5001
Taxonomy
Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
Primary
—
—
Other
Enumeration date
09/03/2012
Last updated
09/03/2012
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