Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | 427 | CO |
NPI | 1407825540 |
---|---|
Provider Name | Dr. Stephen Wesley Leech |
First Address | Pueblo West, CO 81007-4041 |
Second Address | Pueblo, CO 81008-2189 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2006 |
Last Update Date | 20/08/2021 |