Provider Demographics
NPI:1760953640
Name:PRANNO, LISA (PT, DPT, GCS)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:
Last Name:PRANNO
Suffix:
Gender:F
Credentials:PT, DPT, GCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 ASPEN VLG
Mailing Address - Street 2:
Mailing Address - City:ASPEN
Mailing Address - State:CO
Mailing Address - Zip Code:81611-9646
Mailing Address - Country:US
Mailing Address - Phone:970-710-9523
Mailing Address - Fax:
Practice Address - Street 1:401 CASTLE CREEK RD
Practice Address - Street 2:
Practice Address - City:ASPEN
Practice Address - State:CO
Practice Address - Zip Code:81611-1159
Practice Address - Country:US
Practice Address - Phone:970-544-1177
Practice Address - Fax:970-544-1544
Is Sole Proprietor?:No
Enumeration Date:2018-12-17
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO8484225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist