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NPI Code Detail

MEDICARE: MS. MARY REBECCA LEIBOLD PT, MPT, MHS

MEDICARE: MS. MARY REBECCA LEIBOLD PT, MPT, MHS
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
1174400000XSpecialist7221CO
22251X0800XOrthopedic Physical Therapist7221CO

General Provider Information

NPI Number : 1922056639
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MARY REBECCA LEIBOLD PT, MPT, MHS
Provider Business Mailing Address
First Line : 2000 S COLORADO BLVD STE 1000
Second Line :
City : DENVER
State : CO
Zip : 80222-7939
Country : US
Telephone Number : 720-848-8248
Fax Number : 720-848-2058
Provider Business Practice Location Address
First Line : 2000 S COLORADO BLVD STE 1000
Second Line :
City : DENVER
State : CO
Zip : 80222-7939
Country : US
Telephone Number : 720-848-8248
Fax Number : 720-848-2058
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/05/2006
Last Update Date : 03/25/2020

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