Provider Demographics
NPI:1467596593
Name:MARTIN, LEZLIE ANN (PT)
Entity Type:Individual
Prefix:
First Name:LEZLIE
Middle Name:ANN
Last Name:MARTIN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11960 LIONESS WAY
Mailing Address - Street 2:SUITE #280
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-5640
Mailing Address - Country:US
Mailing Address - Phone:303-790-7877
Mailing Address - Fax:303-799-4676
Practice Address - Street 1:11960 LIONESS WAY
Practice Address - Street 2:SUITE #280
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-5640
Practice Address - Country:US
Practice Address - Phone:303-790-7877
Practice Address - Fax:303-799-4676
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2013-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT132182251X0800X
CO117152251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOPT132180Medicare PIN