Individual
LISA ERICKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, ATC, LAT
Contact information
Practice address
230 CALLE BUENA, ALAMOSA, CO 81101-1800
(734) 255-1524
Mailing address
230 CALLE BUENA, ALAMOSA, CO 81101-1800
(734) 255-1524
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
096003256
IL
2255A2300X
Athletic Trainer
Primary
AT.0001250
CO
Other
Enumeration date
04/26/2014
Last updated
04/26/2014
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