Provider Demographics
NPI:1356807986
Name:LEAVENGOOD, DARBY (PT)
Entity type:Individual
Prefix:
First Name:DARBY
Middle Name:
Last Name:LEAVENGOOD
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:DARBY
Other - Middle Name:
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1253 LEYDEN ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-2802
Mailing Address - Country:US
Mailing Address - Phone:970-275-4861
Mailing Address - Fax:
Practice Address - Street 1:1253 LEYDEN ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-2802
Practice Address - Country:US
Practice Address - Phone:970-275-4861
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-19
Last Update Date:2019-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.0016052225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist