Provider Demographics
NPI:1245418961
Name:FEIN, LEAH SWANSON (NCTM)
Entity Type:Individual
Prefix:MS
First Name:LEAH
Middle Name:SWANSON
Last Name:FEIN
Suffix:
Gender:F
Credentials:NCTM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1911 MAIN AVE
Mailing Address - Street 2:SUITE # 260
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81301-5078
Mailing Address - Country:US
Mailing Address - Phone:970-903-5638
Mailing Address - Fax:
Practice Address - Street 1:1911 MAIN AVE
Practice Address - Street 2:SUITE # 260
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-5078
Practice Address - Country:US
Practice Address - Phone:970-903-5638
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-05
Last Update Date:2008-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist