Basic Information
Provider Information
NPI: 1033506993
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LEIFHEIT
FirstName: WENDY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: P.T.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2141 W 132ND AVE
Address2:  
City: WESTMINSTER
State: CO
PostalCode: 802341488
CountryCode: US
TelephoneNumber: 7203662465
FaxNumber:  
Practice Location
Address1: 8670 WOLFF CT
Address2: #115
City: WESTMINSTER
State: CO
PostalCode: 800316956
CountryCode: US
TelephoneNumber: 3036501700
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/17/2015
LastUpdateDate: 04/17/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000XPTL.0003645COY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


Home