Individual
MARK G. LEIFESTE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4770 BASELINE RD, SUITE #300, BOULDER, CO 80303-2666
(303) 449-6577
(303) 447-1880
Mailing address
PO BOX 2086, FORT COLLINS, CO 80522-2086
(303) 444-3443
(970) 221-3730
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
23486
CO
Other
Enumeration date
06/02/2006
Last updated
07/08/2007
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