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General NPI Number Information
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NPI Number | 1578569331
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Entity Type | Individual
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Provider Name | LEILANI MICHELLE PHILLIPS-BORSTAD O.D.
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Gender | Female
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Dates
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Enumeration Date | 06/24/2005
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Last Update Date | 01/09/2009
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Provider Practice Location Address
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Address Line | 5104 S FIELD ST STE C
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City | LITTLETON
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State | CO
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Zip | 80123-7308
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Country | US
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Telephone | 303-979-3937
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Fax | 866-881-3396
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Provider Business Mailing Address
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Address Line | 5104 S FIELD ST STE. C
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City | LITTLETON
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State | CO
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Zip | 80123-7329
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Country | US
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Telephone | 303-979-3937
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Fax | 866-881-3396
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2135
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License Number State | CO
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