MEDICARE: LEIGH ANN ALBERT CERTIFIEDPEDORTHIST

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	224L00000X	Pedorthist	CPED3641	CO

General Provider Information

NPI Number	:	1508663634
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEIGH ANN ALBERT CERTIFIEDPEDORTHIST

Provider Business Mailing Address
First Line	:	2721 S COLLEGE AVE UNIT B5
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-2197
Country	:	US
Telephone Number	:	970-412-9159
Fax Number	:	970-797-1025

Provider Business Practice Location Address
First Line	:	2721 S COLLEGE AVE UNIT B5
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-2197
Country	:	US
Telephone Number	:	916-694-7673
Fax Number	:

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

Provider Enumeration Date	:	02/26/2025
Last Update Date	:	02/26/2025

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