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General NPI Number Information
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NPI Number | 1255693453
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Entity Type | Individual
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Provider Name | GARRET THOMAS LECHTENBERG M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/13/2012
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Last Update Date | 10/14/2025
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Provider Practice Location Address
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Address Line | 1760 E KEN PRATT BLVD STE 205
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City | LONGMONT
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State | CO
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Zip | 80504-5311
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Country | US
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Telephone | 720-718-3930
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Fax | 720-718-0939
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Provider Business Mailing Address
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Address Line | 1760 E KEN PRATT BLVD STE 205
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City | LONGMONT
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State | CO
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Zip | 80504-5311
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Country | US
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Telephone | 720-718-3930
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Fax | 720-718-0939
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 67072
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 62014
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | DR.0076300
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License Number State | CO
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