MEDICARE: LEA HAY PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	7803	CO

General Provider Information

NPI Number	:	1043555741
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEA HAY PT

Provider Business Mailing Address
First Line	:	3255 BLODGETT DR
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80919-4544
Country	:	US
Telephone Number	:	719-229-2718
Fax Number	:	719-247-2523

Provider Business Practice Location Address
First Line	:	2920 N CASCADE AVE STE 202
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80907-6264
Country	:	US
Telephone Number	:	719-247-2523
Fax Number	:	719-982-7330

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/06/2012
Last Update Date	:	04/12/2021

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