Healthcare Provider Details

I. General information

NPI: 1417798182
Provider Name (Legal Business Name): LEAP FOOT AND ANKLE SPECIALISTS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2024
Last Update Date: 06/05/2024
Certification Date: 06/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9255 W ALAMEDA AVE STE F
LAKEWOOD CO
80226-2802
US

IV. Provider business mailing address

9255 W ALAMEDA AVE STE F
LAKEWOOD CO
80226-2802
US

V. Phone/Fax

Practice location:
  • Phone: 303-233-9107
  • Fax:
Mailing address:
  • Phone: 303-233-9107
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MELISSA PAULA HURWITZ
Title or Position: MEMBER
Credential: DPM
Phone: 303-233-9107