Kolesar, Lisa Margaret

Kolesar, Lisa Margaret is an individual health care provider with primary practice located at 7979 W Rifleman St Ste 100 , Boise ID 83704-9066. She recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist is her primary health care specialty. Kolesar, Lisa Margaret can be contacted via phone (208) 377-3850.

Contact Information

Primary practice address
7979 W Rifleman St Ste 100 Boise ID 83704-9066
Phone: (208) 377-3850
Fax: (208) 658-1360
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 1988 Idaho
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer 2255A2300X 234 Idaho

Profile Details

NPI number 1376500124
LBN Legal business name Kolesar, Lisa Margaret
Credentials DPT, ACT/L
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 26th, 2006
Last updated Dec 13th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376500124 NPPES
Idaho Other TD492 BLUE CROSS OF IDAHO
Idaho Other 000010142952 BLUE CROSS OF IDAHO
Idaho MEDICAID 805753950 BLUE CROSS OF IDAHO

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