Individual
DR. LISA R PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
280 EXEMPLA CIR, LAFAYETTE, CO 80026-3370
(303) 338-4545
Mailing address
10350 E DAKOTA AVE, DENVER, CO 80247-1314
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2798
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
022563
KAISER COMMERCIAL NUMBER
CO
05
—
21351058
—
CO
Enumeration date
07/15/2010
Last updated
06/23/2021
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