Provider Demographics
NPI:1689628539
Name:LUTHER, LEAH J (PT)
Entity Type:Individual
Prefix:MRS
First Name:LEAH
Middle Name:J
Last Name:LUTHER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:290 NICKEL ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80020-2183
Mailing Address - Country:US
Mailing Address - Phone:303-460-9151
Mailing Address - Fax:303-460-7443
Practice Address - Street 1:290 NICKEL ST
Practice Address - Street 2:SUITE 200
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80020-2183
Practice Address - Country:US
Practice Address - Phone:303-460-9151
Practice Address - Fax:303-460-7443
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO7732225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
C803858Medicare PIN