Provider Demographics
NPI:1205301728
Name:LEVERAGE O&P, LLC.
Entity type:Organization
Organization Name:LEVERAGE O&P, LLC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/ CERTIFIED ORTHOTIST, PEDORTH
Authorized Official - Prefix:
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:
Authorized Official - Last Name:HENRY
Authorized Official - Suffix:
Authorized Official - Credentials:BOCO, BOCPED
Authorized Official - Phone:970-372-1273
Mailing Address - Street 1:7208 WOODROW DR
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-8207
Mailing Address - Country:US
Mailing Address - Phone:970-372-1273
Mailing Address - Fax:970-797-1865
Practice Address - Street 1:7208 WOODROW DR
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-8207
Practice Address - Country:US
Practice Address - Phone:970-372-1273
Practice Address - Fax:970-797-1865
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-11
Last Update Date:2018-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotistGroup - Multi-Specialty
No224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetistGroup - Multi-Specialty