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General NPI Number Information
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NPI Number | 1114626041
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Entity Type | Individual
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Provider Name | NICOLE LEON DPT
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Gender | Female
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Dates
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Enumeration Date | 02/28/2023
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Last Update Date | 02/28/2023
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Provider Practice Location Address
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Address Line | 1600 PRAIRIE CENTER PKWY
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City | BRIGHTON
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State | CO
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Zip | 80601-4006
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Country | US
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Telephone | 505-498-1841
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Fax |
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Provider Business Mailing Address
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Address Line | 625 FLAGLER RD
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City | FORT COLLINS
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State | CO
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Zip | 80525-7030
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Country | US
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Telephone | 505-321-2425
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | PTL.004116
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License Number State | CO
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