Individual
MRS. LISA LYNN RAYMOND
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MSPT
Contact information
Practice address
190 TALISMAN DR, UNIT D4, PAGOSA SPRINGS, CO 81147
(970) 731-1888
(970) 731-1889
Mailing address
190 TALISMAN DR, UNIT D4, PAGOSA SPRINGS, CO 81147
(970) 731-1888
(970) 731-1889
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4092
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
28329767
—
CO
01
—
PE647283
BCBS
CO
Enumeration date
01/10/2006
Last updated
07/08/2007
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