Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251S0007X | Physical Therapist - Sports | PTL-8370 | CO |
NPI | 1275891905 |
---|---|
Provider Name | Mrs. Brianna L Lancaster |
First Address | Greenwood Village, CO 80111-2803 |
Second Address | Greenwood Village, CO 80111-2803 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2012 |
Last Update Date | 01/05/2012 |