Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic |
NPI | 1033601042 |
---|---|
Provider Name | Haley Leo |
First Address | Vail, CO 81658-7520 |
Second Address | Vail, CO 81657-5242 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2018 |
Last Update Date | 27/01/2022 |