Provider Demographics
NPI:1447334255
Name:SUTTON, LESLIE ANN (PT)
Entity type:Individual
Prefix:MS
First Name:LESLIE
Middle Name:ANN
Last Name:SUTTON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2924 TEAL EYE CT
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526-6282
Mailing Address - Country:US
Mailing Address - Phone:970-217-7011
Mailing Address - Fax:970-416-1288
Practice Address - Street 1:2350 LIMON DR
Practice Address - Street 2:UNIT 258
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-7643
Practice Address - Country:US
Practice Address - Phone:970-231-9579
Practice Address - Fax:303-452-3087
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2008-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2213225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO810598Medicare PIN
COC810598Medicare PIN