Provider Demographics
NPI:1922056639
Name:LEIBOLD, MARY REBECCA (PT, MPT, MHS)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:REBECCA
Last Name:LEIBOLD
Suffix:
Gender:F
Credentials:PT, MPT, MHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:2000 S COLORADO BLVD STE 1000
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-7939
Mailing Address - Country:US
Mailing Address - Phone:720-848-8248
Mailing Address - Fax:720-848-2058
Practice Address - Street 1:2000 S COLORADO BLVD STE 1000
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-7939
Practice Address - Country:US
Practice Address - Phone:720-848-8248
Practice Address - Fax:720-848-2058
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2020-03-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO7221174400000X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No174400000XOther Service ProvidersSpecialist