Provider Demographics
NPI:1255922183
Name:COLLIER, LEAMON JEFFREY III (STNA, CPT-ACSM)
Entity type:Individual
Prefix:MR
First Name:LEAMON
Middle Name:JEFFREY
Last Name:COLLIER
Suffix:III
Gender:M
Credentials:STNA, CPT-ACSM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11651 NORBOURNE DR APT 501
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45240-2165
Mailing Address - Country:US
Mailing Address - Phone:513-406-0813
Mailing Address - Fax:
Practice Address - Street 1:11651 NORBOURNE DR APT 501
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45240-2165
Practice Address - Country:US
Practice Address - Phone:513-306-0813
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-02
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH501146430706376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376K00000XNursing Service Related ProvidersNurse's AideGroup - Multi-Specialty