Provider Demographics
NPI:1619683935
Name:LENOWICZ, ALBERT JOHN (LMT, NMT)
Entity Type:Individual
Prefix:
First Name:ALBERT
Middle Name:JOHN
Last Name:LENOWICZ
Suffix:
Gender:M
Credentials:LMT, NMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3246 CENTENNIAL BLVD # 221
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-4077
Mailing Address - Country:US
Mailing Address - Phone:315-807-6776
Mailing Address - Fax:
Practice Address - Street 1:4224 N NEVADA AVE STE 200
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-4368
Practice Address - Country:US
Practice Address - Phone:315-807-6776
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-30
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMT.0025468225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist