Individual
ELISA LEAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6170 LEHMAN DR STE 103, COLORADO SPRINGS, CO 80918-3443
(719) 210-8733
(719) 597-5170
Mailing address
6170 LEHMAN DR STE 103, COLORADO SPRINGS, CO 80918-3443
(719) 210-8733
(719) 597-5170
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
04K999
CO
Other
Enumeration date
12/16/2015
Last updated
12/16/2015
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