Provider Demographics
NPI:1992844732
Name:LEIBBRANDT, BRUCE DOUGLAS (CMT)
Entity Type:Individual
Prefix:MR
First Name:BRUCE
Middle Name:DOUGLAS
Last Name:LEIBBRANDT
Suffix:
Gender:M
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7177 S MAGNOLIA CIR
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-1120
Mailing Address - Country:US
Mailing Address - Phone:303-759-8830
Mailing Address - Fax:
Practice Address - Street 1:7400 E ARAPAHOE RD
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-1279
Practice Address - Country:US
Practice Address - Phone:303-224-9920
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist