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1689812257
LISA J THACKWELL
COLORADO SPRINGS, CO
NPI
1689812257
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: CA PA22118)
Enumeration Date
2009-02-04
Last Update Date
2022-11-30
Business Address
LISA J THACKWELL P.A.-C.
4190 E WOODMEN RD STE 100
COLORADO SPRINGS, CO 80920-8075
Phone number: 719-632-4455
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Mailing Address
LISA J THACKWELL P.A.-C.
960 E GREEN ST SUITE 292
PASADENA, CA 91106-2412
Phone number: 626-449-4494
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