Provider Demographics
NPI:1619137908
Name:DURAN, LESLIE SAUERESSIG (MSPT)
Entity Type:Individual
Prefix:MRS
First Name:LESLIE
Middle Name:SAUERESSIG
Last Name:DURAN
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1348
Mailing Address - Street 2:
Mailing Address - City:PONCHA SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:81242-1006
Mailing Address - Country:US
Mailing Address - Phone:303-249-9718
Mailing Address - Fax:855-937-0799
Practice Address - Street 1:217 SUMMITVIEW LN
Practice Address - Street 2:
Practice Address - City:PONCHA SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:81201-9254
Practice Address - Country:US
Practice Address - Phone:303-759-4221
Practice Address - Fax:303-756-1656
Is Sole Proprietor?:No
Enumeration Date:2008-06-11
Last Update Date:2020-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO8036225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist