Individual
LEISHA ANN MENCKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
8369 OTIS DR, ARVADA, CO 80003-1239
(303) 887-3360
Mailing address
8369 OTIS DR, ARVADA, CO 80003-1239
(303) 887-3360
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4032
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
25230328
—
CO
Enumeration date
05/03/2007
Last updated
07/08/2007
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