Provider Demographics
NPI:1477639433
Name:LEAHY, PAUL MICHAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:MICHAEL
Last Name:LEAHY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 S UNION BLVD STE 230
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80910-3125
Mailing Address - Country:US
Mailing Address - Phone:719-473-7000
Mailing Address - Fax:719-473-7479
Practice Address - Street 1:175 S UNION BLVD STE 230
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80910-3125
Practice Address - Country:US
Practice Address - Phone:719-473-7000
Practice Address - Fax:719-473-7479
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2282111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor