Individual
LISA K JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
717A SYLVAN LAKE ROAD, EAGLE, CO 81631
(970) 926-4600
Mailing address
PO BOX 5892, EAGLE, CO 81631-5892
(410) 259-5603
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT.0015849
CO
Other
Enumeration date
02/23/2018
Last updated
02/23/2018
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