Provider Demographics
NPI:1861462533
Name:ALBUCHER, LISA H (MPT)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:H
Last Name:ALBUCHER
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 771197
Mailing Address - Street 2:
Mailing Address - City:STEAMBOAT SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80477-1197
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:345 S LINCOLN AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:STEAMBOAT SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80487-8907
Practice Address - Country:US
Practice Address - Phone:970-870-3484
Practice Address - Fax:970-879-5200
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO7923225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO57385726Medicaid
CO803624Medicare ID - Type Unspecified