Provider Demographics
NPI:1508663634
Name:ALBERT, LEIGH ANN (CERTIFIEDPEDORTHIST)
Entity type:Individual
Prefix:
First Name:LEIGH ANN
Middle Name:
Last Name:ALBERT
Suffix:
Gender:
Credentials:CERTIFIEDPEDORTHIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2721 S COLLEGE AVE UNIT B5
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-2197
Mailing Address - Country:US
Mailing Address - Phone:970-412-9159
Mailing Address - Fax:970-797-1025
Practice Address - Street 1:2721 S COLLEGE AVE UNIT B5
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-2197
Practice Address - Country:US
Practice Address - Phone:916-694-7673
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-26
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCPED3641224L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224L00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPedorthistGroup - Single Specialty