Provider Demographics
NPI:1528330206
Name:BOALS, LISA (DVM)
Entity type:Individual
Prefix:DR
First Name:LISA
Middle Name:
Last Name:BOALS
Suffix:
Gender:F
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 E DRY CREEK ROAD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80122-2625
Mailing Address - Country:US
Mailing Address - Phone:303-794-2697
Mailing Address - Fax:303-794-0677
Practice Address - Street 1:250 E DRY CREEK ROAD
Practice Address - Street 2:SUITE 106
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80122-2625
Practice Address - Country:US
Practice Address - Phone:303-794-2697
Practice Address - Fax:303-794-0677
Is Sole Proprietor?:No
Enumeration Date:2012-01-27
Last Update Date:2012-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO8674174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian