Provider Demographics
NPI:1982935631
Name:WIMBS, LESLIE ANN (PT, DPT)
Entity Type:Individual
Prefix:MRS
First Name:LESLIE
Middle Name:ANN
Last Name:WIMBS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:MS
Other - First Name:LESLIE
Other - Middle Name:ANN
Other - Last Name:CHERRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8400 E PRENTICE AVE
Mailing Address - Street 2:STE 700
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-2912
Mailing Address - Country:US
Mailing Address - Phone:720-851-9694
Mailing Address - Fax:303-840-7073
Practice Address - Street 1:8400 E PRENTICE AVE
Practice Address - Street 2:STE 700
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-2912
Practice Address - Country:US
Practice Address - Phone:720-851-9694
Practice Address - Fax:303-840-7073
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-20
Last Update Date:2013-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO10567225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO294455YQG6Medicare PIN