Provider Demographics
NPI:1073929592
Name:GROSHONG, LESLI (DVM)
Entity Type:Individual
Prefix:DR
First Name:LESLI
Middle Name:
Last Name:GROSHONG
Suffix:
Gender:F
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2323 55TH ST
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-2806
Mailing Address - Country:US
Mailing Address - Phone:303-442-4030
Mailing Address - Fax:303-443-8375
Practice Address - Street 1:2323 55TH ST
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-2806
Practice Address - Country:US
Practice Address - Phone:303-442-4030
Practice Address - Fax:303-443-8375
Is Sole Proprietor?:No
Enumeration Date:2014-07-03
Last Update Date:2014-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5444174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian