Individual
MICHAEL C LEINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1025 PENNOCK PL STE 114, FORT COLLINS, CO 80524-3257
(970) 495-8800
(970) 495-8820
Mailing address
1025 PENNOCK PL STE 114, FORT COLLINS, CO 80524-3257
(970) 495-8800
(970) 495-8820
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
02003828A
IN
207Q00000X
Family Medicine Physician
Primary
DR.0054177
CO
390200000X
Student in an Organized Health Care Education/Training Program
11014445A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01146658
RR MEDICARE PTAN
IN
Enumeration date
06/25/2008
Last updated
04/06/2020
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